^ONOFFICIAL EEMEBIES l&37i! I 1 £iis~- 3 ■'ISa 0003b3?S b This book may be kept FOURTEEN DAYS A fine the book U of TWO CENTS kept over time. will be charged for each day NEW AND NONOFFICIAL ^^ REMEDIES, 1937 ^^^ Containing Descriptions of the Articles Which Stand Accepted by the Council on Pharmacy and Chemistry of the American Medical Association on January 1, 1937 American Medical Association 535 North Dearborn Street CHICAGO Copyright, 1937, by American Medical Association 535 North Dearborn Street CHICAGO PREFACE New and Nonofficial Remedies is a book in which are listed and described the articles that stand accepted by the Council on Pharmacy and Chemistry of the American Medical Associa- tion on January 1 of the year of publication. The descriptions of accepted articles are based in part on investigations made by, or under the direction of the Council and in part on evidence or information supplied by the manufacturer or his agents. Statements made by those commercially interested are examined critically and admitted only when they are supported by other evidence or when they conform t(j known facts. The following articles which appeared in New and Non- official Remedies for 1936 have been omitted by action of the Council because they conflict with the rules that govern the recognition of articles or because their distributors did not present evidence to demonstrate their continued eligibility : Flumerin-H. W. & D. ; Mercuric Biniodidc Oil Solution in Ampules. H. W. & D. The following articles have been omitted as being off the market : Ampule Glucose (U. S. P. Dextrose) Solution, 20 cc. size. 50 cc. size and 100 cc. size (Lederle) ; Ampules Lipoiodine- Ciba Diagnostic. 5 cc. ; Ampuls Oleo-Bi-Roche, 2 cc. ; Anti- anthrax Serum-Mulford, packages of 2 syringes (10 cc. each) ; Bouillon Filtrate Tuberculin, "B. F." (Gilliland) ; Butesin Pic- rate Ointment; Capsules Ipral-Sodium, 2 grains; Ipral Sodium Tablets, •>4 and 2 grains; Cholera Vaccine (Prophylactic) (Lederle), packages of two 10 cc. vials; Cymarin ; Diphtheria Toxin-Antitoxin Alixture, 0.1 L+ (Goat) (Lederle) ; Diph- theria Toxin for the Schick Test (Gilliland) ; Diphtheria Toxin for Schick Test in Peptone Solution (Lederle), one vial (20 tests) ; Diphtheria Toxoid (Lederle). packages of two 1 cc. syringes (immunization treatment). 1 syringe (one sensitivity test), and 1 vial (five sensitivity tests); lopax ; Liver Extract- Fairchild ; Lunosol Capsules, 6 grains ; Normal Horse-Serum (Lederle). 100 cc. vial and 30 cc. vial; Papaverine Sulfate; Oscodal Tablets (Winthrop Chemical Co.) ; Papaverine Sul- phate-Roche, Ampuls ; Papaverine Sulphate Tablets-Roche, 0.04 Gm. ; Pirquet Test for Tuberculosis (Bovine Type) (S. & D.) ; Quinidine Sulphate Capsules (Lederle), 5 grains (0.325 Gm.) and 3 grains (0.2 Gm.) ; Rabies Vaccine-Lederle (Semple Method), packages of 14 syringes; Rabies Vaccine, Semple Method (Lee); Soluble Stomach Extract-Fairchild ; Sterine Ampoules Mercury Salicylate 0.097 Gm. (1^ grain) (Abbott) ; Tuberculin B. F. (Bouillon Filtrate) (Cutter) ; Tuberculin B. F. (Bovine) (Cutter) ; Tuberculin Intracutaneous for Mantoux Test (N. D. Co.), packages of two 5 cc. ampules; Tuberculin O. T. Bovine (Cutter) ; Typhoid Bacterin (Prophylactic) (Abbott); Typhoid Combined Vaccine (Prophylactic) (Lederle). 4 PREFACE packages of 30 vials, and one 20 cc. vial; Typiioid Prophylactic (Cutter), 1 syringe. The grouping together of articles having similar composition or actions is continued in this edition, each group being pre- ceded by a general discussion. These general articles have been revised when necessary to bring them up to date. Such revisions have been made this year in the articles : Arsenic Compounds ; Compounds Containing Trivalent Arsenic ; Com- pounds Containing Pentavalent Arsenic ; Bismuth Compounds ; Epinephrine and Related Praparations ; Iodine Compounds ; Iodine Compounds for Systemic Use; Mercury and Mercury Compounds ; Pituitary Gland ; Salicylic Acid Compounds ; Serums and Vaccines ; Antipneumococcic Serums ; Silver Prep- arations ; Tannic Acid Derivatives. Last year the section of Vitamin Foods was taken out of the chapter Medicinal Foods and set up as an independent category. This year the chapter name "Medicinal Foods" is being aban- doned and is replaced by a chapter describing Carbohydrate Foods chiefly Dextrose. A rearrangement has been made in the chapter "Organs of Animals" by including under that head Insulin, Epinephrine, Liver and Stomach Preparations. The "List of Articles and Brands Accepted but not Described in N. N. R.," which was formerly the "List of Exempted Articles" was originally intended primarily for offi- cial articles marketed under the official name with no unusual or extraordinary claims. Official articles still marketed under proprietary names were therefore described in the body of the book. The Council recently decided, tentatively, to_ set up in the body of the book descriptions of accepted official articles in those cases in which there is a brand marketed under a proprietary name. This revision has been made in the present volume, products marketed under proprietary names appearing in bold face type and those marketed under the official (nonproprietary) names, or an unessential modification of the names, appearing in light face capitals. Its continuance will depend in the further action of the council. The statements concerning the actions, uses, or dosage of the following have been revised: Aminoacetic Acid; Antimony Thioglycollamide ; Arsphenamine : Cevitamic Acid ; Digifoline- Ciba ; Diluted Erythrityl Tetranitrate : Diodrast ; Diphtheria Toxin for the Schick Test ; Diphtheria Toxoid ; Hippuran ; locamfen ; lodobismitol with Saligenin ; Mapharsen ; Merbaphen ; Neoarsphenamine Poison Ivy Extract-Lederle (In Almond Oil) ; Psyllium Seed: Rabies Vaccine-Gilliland (Semple Method); Sal-Ethyl Carbonate: Salyrgan ; Spirosal ; Staphylococcus Toxoid; Tetanus-Gas-Gangrene Antitoxin (Combined) (Prophy- lactic) Refined and Concentrated-P. D. & Co.; Thio-Bismol; Thyroxine ; Sodium lodobismuthite ; Soluble lodophthalein ; Tryparsamide. The statement of composition, of standard of purity, identity, or strength, or of physical qualities has been revised in the cases of the following: Allergenic Extracts-Mulford (S, & PREFACE 5 D.) ; Alurate; Apothesine and Adrenalin Hypodermic Tablets; Arheol ; Azochloramid ; Brometone ; Brucella Melitensis Vac- cine-Lederle ; Butyn Ointment-M. E. S. Co. ; Chloretone Inhal- ant ; Copper Citrate Ointment (5 per cent)-M. E. S. Co.; Copper Citrate Ointment (10 per cent)-M. E. S. Co.; Diodrast ; Diphtheria Toxoid, Alum Precipitated (Refined) ; Erysipelas Streptococcus Antitoxin, Globulin-Lederle-Modified ; Glaseptic Ampoules Mercury Succinimide-P, D. & Co.. 0.01 Gm.; Holo- caine Ointment-M. E. S. Co. ; Holocaine and Adrenalin Oint- ment-M. E. S. Co. ; Isacen ; Mead's Newfoundland Cod Liver Oil ; Mead's Newfoundland Cod Liver Oil. Flavored ; Nason's Palatable Cod Liver Oil; Pollen Extracts-Mulford (S. & D.) ; Polyanaerobic Antitoxin, Prophylactic (Tetanus-Gas Gangrene Antitoxin) (Cutter) ; Polyanaerobic Antitoxin, Therapeutic (Gas Gangrene Antitoxin) (Cutter); Silver Lactate; Sodium Cacodylate ; Squibb Cod Liver Oil ; Squibb's Mineral Oil with Agar ; Squibb's Mineral Oil with Agar and Phenolphthalein ; Surgical Maggots-Lederle ; Tetanus-Gas-Gangrene Antitoxin (Combined) (Prophylactic) Refined and Concentrated-P. D. & Co. The actions and uses of many of the pharmacopeial drugs may be found in Useful Drugs, where they are listed under the Latin names. Solutions referred to in the descriptions of qualitative and quantitative tests are, unless otherwise stated, of the strength described in the U. S. Pharmacopeia-XL In the description of an article, the statement, "No U. S. patent." means that the manufacturer of that article has trans- mitted to the Council no claim of patent protection for it ; and the statement. "No U. S. trademark," signifies that the manu- facturer has claimed no trademark registration in connection with the name of the article. In the descriptions of solutions in ampules, it is understood that the ampule contains a sufficient excess to permit with- drawal and administration of the stated content; market pack- ages of accepted ampule solutions are required to bear a statement to this effect. This does not apply to ampules con- taining multiple doses, as, for instance, vaccines. During the year 1937 descriptions of such other medicinal substances as are accepted by the Council for New and Non- official Remedies will be published from time to time in The Journal A. M. A., and will be reprinted in the form of supple- ments, which will be sent to those who purchase this book. Paul Nicholas Leech, Secretary. MEMBERS OF THE COUNCIL E. M. Bailey, Ph.D. ------ New Haven, Conn. Chemist in Charge, Connecticut Agricultural Experiment Station David P. Barr, A.B., M.D., LL.D. - - - St. Louis, Mo. Professor of Medicine, Washington University J. Howard Brown, Ph.D., Sc.D. - - - - Baltimore, Md. Associate Professor of Bacteriology, Johns Hopkins University School of Medicine S. W. Clausen, M.D. ------- Rochester, N. Y. Professor of Pediatrics, School of Medicine, University of Rochester H. N. Cole, PhB., M.D. -------- Cleveland Associate Clinical Professor of Dermatology, Western Reserve School of Medicine C. W. Edmunds, M.D. ------ Ann Arbor, Mich. Professor of Materia Medica and Therapeutics, University of Michigan Medical School Morris Fishbein, M.D. --------- Chicago Editor of The Journal of the American Medical Association R. A. Hatcher, Phar.M., M.D., Sc.D. - - - New York Professor of Pharmacology, Cornell University Medical College Ernest E. Irons, M.D., Ph.D. ------- Chicago Clinical Professor of Medicine, Rush Medical College Paul Nicholas Leech, Ph.D. ------- Chicago Secretary of the Council, Director of the Chemical Laboratory of the American Medical Association G. W. McCoy, ALD. ------- Washington, D. C. Director of the National Institute of Health, United States Public Health Service E. M. Nelson, Ph.D. ------ Washington, D. C. Chief, Vitamin Division, Food and Drug Administration, U. S. Department of Agriculture W. W. Palmer. B.S.. ALD. ------- New York Bard Professor of Medicine, Columbia University College of Physicians and Surgeons Wm. C. Rose, Ph.D. --------- Urbana, III. Professor of Biochemistry, University of Illinois G. H. Simmons, M.D., LL.D. ------- Chicago Editor Emeritus of The Journal of the American Medical Association Torald Sollmann, M.D. -------- Cleveland Vice-Chairman of the Council; Professor of Pharmacology and Materia Medica, Western Reserve University School of Medicine LIST OF CONSULTANTS Allen, Edgar, Ph.D New Haven, Conn. Allen, W. M., M.D Rochester, N. Y. Anderson, W. E., B.S., M.A New Haven, Conn. Bacon, Asa S Chicago, 111. Bayne-Jones, S., M.D New Haven, Conn. Binkley, George W., M.D Cleveland, Ohio. Blackfan, Kenneth D., M.D Boston, Mass. Bowers, Ralph, M.D New York, N. Y. Boynton, V. R., M.D Denver, Colo. Branham, Sarah E., M.D Washington, D. C. Braasch, William F., M.D Rochester, Minn. Brewer, John H., B.A., M.A Baltimore, Md. Bullowa, Jesse G. M., M.D New York, N. Y. Burdick. Carl G., M.D New York, N. Y. Burlingham, Louis H., M.D St. Louis, Mo. Cecil, Russell L., M.D New York, N. Y. Chamberlain, George W., M.D Philadelphia, Pa. Chandler, Earl R Milwaukee, Wis. Christian, Henry A Boston, Mass. CoUip, J. B., M.D Montreal, Quebec Cook, E. Fullerton. Ph.M Philadelphia, Pa. Cori, Carl, M.D St. Louis, Mo. Corner, G. W., M.D Rochester, N. Y. Cowgill, George R.. Ph.D New Haven, Conn. Crafts, Grace. R.N Madison, Wis. Crane, E. J., B.A Columbus, Ohio Crohn, Nathan N., M.D Chicago, 111. Cutler, E. C, M.D Boston, Mass. Davis, Loyal, M.D Chicago, 111. Dick, Gladys, M.D Chicago, 111. Doisy, Edward A., Ph.D St. Louis, Mo. Douglass, Marion. M.D Cleveland, Ohio DuBois, Eugene F., M.D New York, N. Y. Dunstan, E. M., M.D Dallas, Tex. Dutcher, R. Adams, M.S., A.M State College, Pa. Dyer, R. E., M.D Washington, D. C. Ecker, E. E., Ph.D Cleveland, Ohio Eddy, Nathan B., M.D Ann Arbor, Mich. Elvehjem, C. A., Ph.D Madison, Wis. Engle, E. T., Ph.D New York, N. Y. Evans, H. M., M.D Berkeley, Calif. Ewing, James E., M.D New York, N. Y. Fallis, L. S., M.D Detroit, Mich. Faxon, N. W., M.D Boston, Mass. Fisher, Harry J., Ph.D New Haven, Conn. Frank. R. T., M.D New York, N. Y. Furstenburg, Albert Carl, M.D Ann Arbor, Mich. Garber, F. W., M.D.. Muskegon, Mich. Gold, Harry. M.D New York, N. Y. Goldblatt. Harry, M.D Cleveland, Ohio Gordon, Samuel M., Ph.D Chicago, 111. Graham, Evarts A., M.D St. I^ouis, Mo. Hanzlik, P. J., M.D San Francisco, Calif. Hart, E. B., B.S Madison, Wis. Harvey, Samuel C, M.D New Haven, Conn. Hayman, Joseph M., M.D Cleveland, Ohio Hines, J. H., M.D Atlanta, Ga. 8 LIST OF CONSULTANTS Hisaw, F. L., Ph.D Cambridge, Mass. Hodges, Paul C, M.D., Ph.D Chicago, 111. Hudson, C. W., Ph.D Washington, D. C. King, C. G., Ph.D Pittsburgh, Pa. Kneeland, Yale, Jr., M.D New York, N. Y. Koch, F. C, Ph.D Chicago, 111. Lahey, Frank H., M.D Boston, Mass. Lenhart, Carl H., M.D Cleveland, Ohio Levene, P. A., M.D New York, N. Y. Lewis, Dean, M.D Baltimore, Md. Lewis, J. M., M.D New York, N. Y. Lewis, Howard B., Ph.D Ann Arbor, Mich. Loeb, Leo, M.D St. Louis, Mo. Luckhardt, Arno B., M.D., Ph.D Chicago, 111. Lundy, John S., M.D Rochester, Minn. Marrian, G. F., M.D Toronto, Ontario Martin, Kirby A., M.D New York, N. Y. Mattill, Henry A., Ph.D Iowa City, la. McCollum, E. v., Ph.D Baltimore, Md. McLester, James S., M.D Birmingham, Ala. McMillan, Parker J Baltimore, Md. Meleney, Frank L., M.D New York, N. Y. Milhorat, Ade T., M.D New York, N. Y. Miller, Franklin R., M.D Cleveland, Ohio Moore, C. R., Ph.D Chicago, 111. Moore, J. J., M.D Chicago, III. Moyer, Carl Alfred, A.B., M.S Ann Arbor, Mich. Naffziger, Howard C, M.D San Francisco, Calif. Nelson, E, E., M.D., Ph.D Ann Arbor, Mich. Orr, Thomas G., M.D Kansas City, Kans. Pendergrass, E. P., M.D Philadelphia, Pa. Plummer, Norman H., M.D New York, N. Y. Powers, Grover F., M.D New Haven, Conn. Probey, T. F., B.A Washington, D. C. Rees, Maurice H., M.D Denver, Colo. Riddle, Oscar, Ph.D.... Cold Spring Harbor, Long Island, N. Y. Rose, Mary Swartz, Ph.D New York, N. Y. Rowntree, L. G., M.D Philadelphia, Pa. Sargeant, H. W., M.D Milwaukee, Wis. Schmidt, Erwin R., M.D Madison, Wis. Sherman, H. C, Ph.D New York, N. Y. Smith, A. H., Ph.D New Haven, Conn. Smith, P. E., Ph.D New York, N. Y. Smith, Ralph G., M.D., Ph.D Ann Arbor, Mich. Stainsby, W. J., M.D New York, N. Y. Stevens, Franklin A., M.D New York, N. Y. Sullivan, Maurice, M.D Cleveland, Ohio Templeton, F. E., M.D Chicago, 111. Thornton, E. S., M.D Muskegon, Mich. Turnbull, W. G., M.D Philadelphia, Pa. Turner, C. W., Ph.D Columbia, Mo. Veldee, Milton V., M.D Washington, D. C. Vidrine, Arthur, M.D New Orleans, La. Vos, B. J., Jr., Ph.D Chicago, III. Wangensteen, Owen H., M.D Minneapolis, Minn. Webster, Bruce, M.D. New York. N. Y. Widmann, Bernard P., M.D Philadelphia. Pa. Wood, Francis Carter. M.D New York, N. Y. Workman. W. G.. M.D Washington, D. C. OFFICIAL RULES OF THE COUNCIL ON PHARMACY AND CHEMISTRY Introduction Object of the Rules. — The following rules have been adopted by the Council primarily with the object of protecting the medical profession and the public against fraud, undesirable secrecy and objectionable advertising in connection with pro- prietary medicinal articles. Contents of N. N. R. — The book New and Nonofficial Remedies con- tains a description of proprietary articles which have been accepted as conforming to the rules of the Council; of such simple nonproprietary and nonofficial substances as seem of sufficient importance to warrant their inclusion, and of simple pharmaceutical preparations, the inclusion of which is believed to give useful information to physicians. Attitude on Mixtures. — For admission to N. N. R., proprietary phar- maceutic mixtures must comply with the rules; and, to determine such compliance, they will be investigated by the Council. The Council, how- ever, endorses the principle that prescriptions should be written on the basis of the therapeutic effects of the individual ingredients. For this reason, it includes in this book only those mixtures that present some real advantage. Rules Governing the Admission of Proprietary Articles to the Book New and Nonofficial Remedies Definition of Proprietary Articles. — The term "pro- prietary article," in this place, shall mean any chemical, drug or similar preparation used in the treatment of diseases, if such article is protected against free competition, as to name, product, composition or process of manufacture, by secrecy, patent or copyright, or by any other means. Rule 1. — Composition. — No article will be accepted _ for inclusion in the book New and Nonofficial Remedies or retained therein unless its composition is published. For simple sub- stances, the scientific name and the chemical formula, rational or structural, if known, should be supplied. For mixtures, the ainount of each active medicinal ingredient in a given quantity of the article must be stated. The general composition of the vehicle, its alcoholic percentage and the identity of the preser- vatives must be furnished. Rule 2. — Identification. — No article will be accepted or retained unless suitable tests for determining its composition are furnished to the Council. In the case of chemical com- pounds, these shall consist of tests for identity and purity. In the case of mixtures, description of methods for determining the amount and strength of the potent ingredients shall be furnished, if practicable. Rule 3. — Direct Advertising. — No article that is advertised to the public will be accepted or retained; but this rule shall 10 NEW AND NONOFFICIA]^ REMEDIES not apply to (a) disinfectants, germicides and antiseptics, pro- vided the advertising is limited to conservative recommendations for their use as prophylactic applications to superficial cuts and abrasions of the skin and to the mucous surfaces of the mouth, pharynx and nose (but not to those of the eye, and the gastro- intestinal and genito-urinary tracts) and provided they are not advertised as curative agents (see comments to Rule 3) ; (b) liquid petrolatum and simple preparations of liquid petrolatum, agar and simple preparations of agar, and similar preparations which act because of their bulk, provided that such lay adver- tising carries a warning that agar and similar preparations may be harmful in colitis ; (c) other agents about which the public should be informed and which would not lead to harmful self- medication provided (1) that they are not advertised as curative agents and provided (2) that the advertising to the public does not go beyond that passed by the Council for physicians (Rule 6). Rule 4. — Indirect Advertising. — No article will be accepted or retained if the label, package or circular accompanying the package contains the names of diseases in the treatment of which the article is said to be indicated. The therapeutic indi- cations and properties may be stated, provided such statements do not suggest self -medication. Dosage may be indicated. (This rule shall not apply to remedies with which self- medication is altogether improbable, to vaccines and antitoxins, or to directions for administering or applying remedies when similar immediate, heroic treatment is indicated.) Rule 5. — False Claiais as to Origin. — No article will be accepted or retained concerning which the manufacturer or his agents make false or misleading statements as to source, raw material from which made or method of collection or prepa- ration. Rule 6. — Unwarranted Therapeutic Claims. — No article will be accepted or retained concerning which the manufacturer or his agents make unwarranted, exaggerated or misleading statements as to the therapeutic value. Rule 7. — Poisonous Substances. — The principal label on an article containing "poisonous" or "potent" substances must state plainly the amount of each of such ingredients in a given quan- tity of the product. Rule 8. — Objectionable Names. — Proprietary names for medicinal articles will be recognized only when the Council shall deem the use of such exclusive names to be in the interest of public welfare. Names which are misleading or which sug- gest diseases, pathologic conditions or therapeutic indications will not be recognized (the provision against therapeutically suggestive names does not apply to serums, vaccines and anti- toxins). In the case of pharmaceutic preparations or mix- tures, the name must be so framed as to indicate clearly the most potent ingredients. Coined names for salts will not be OFFICIAL RULES OF THE COUNCIL 11 accepted unless such names indicate the components of the salt ; coined names for new substances marketed as pharmaceutic preparations will not be accepted unless such names indicate definitely the type or dosage form of the article. Ride 9. — Patented Products and Protected Names. — If the article is patented — either process or product, or both — the number of such patent or patents must be furnished to the Council. Furthermore, if the name of an article is registered, or the label copyrighted, the registration (trademark) number and a copy of the protected label should be furnished the Council. In case of registration in foreign countries, the name under which the article is registered should be supplied. Rule 10. — Unscientific and Useless Articles. — No article will be accepted or retained which, because of its unscientific composition, is useless or inimical to the best interests of the public or of the medical profession. Rule 11. — Policies of Firms Detrimental to Rational Therapeutics. — The Council will not accept or retain, if already accepted, the articles of a firm if in the opinion of the Council the policies of such a firm are clearly detrimental to the welfare of the public and to medicine. Explanatory Comments on the Rules Purpose and Methods of the Council. — The Council on Pharmacy and Chemistry was established in 1905 by the Amer- ican Medical Association, primarily for the purpose of gathering and disseminating such information as will protect the medical profession in the prescribing of proprietary medicinal articles. In pursuance of this object, the Council examines the articles on the market as to their compliance with definite rules designed to prevent fraud, undesirable secrecy and the abuses which arise from advertising directly or indirectly to the laity. Such articles as appear to conform to the rules are accepted, and their essential features are described in the annual publication of the Council, New and Nonofficial Remedies, if they come within the scope of this book. Submitted Evidence. — These descriptions are based in part on investigations made by, or under the direction of, the Coun- cil, but in part also on evidence or information supplied by the manufacturer or his agents. Such interested statements are examined critically, and are admitted only if they appear to be in conformity with the evidence. It is, however, manifestly impossible for the Council to investigate the composition of every complex pharmaceutic mixture, or to check thoroughly every therapeutic claim; it can give only unbiased judgment on the available evidence. Criticisms and corrections of the descriptions which may aid in the revision of the matter will be appreciated. Previous Noncompliance and Fraud. — The Council judges an article entirely by the facts in evidence at the time of its 12 NEW AND NONOFFICIAL REMEDIES admission. Previous noncompliance with the rules (short of intentional fraud) does not prevent the favorable consideration of an article which is in accord with existing rules. Reconsideration. — Infringements of the rules after accept- ance of an article for New and Nonofficial Remedies, or the discovery that the Council's information was incorrect, will cause the acceptance to be reconsidered. An article is accepted for New and Nonofficial Remedies, and will continue to be included in the book, with the understanding that serious viola- tions of the rules, after acceptance, will be followed by the omission of the article and publication of the reasons for such omission. Acceptance Not an Indorsement. — The Council desires physi- cians to understand that the admission of an article does not imply a recommendation. Acceptance simply means that no conflict with the rules has been found by the Council. Seal of Acceptance. — For articles which are accepted for inclusion in New and Nonofficial Remedies or in the List of Articles and Brands Accepted by the Council but Not Described in N. N. R., the Council permits the use of its official seal of acceptance, with the following stipulations: (1) The seal may be used on the packages of an article and in the advertising for it. (2) The seal, if used, must be the only seal of such character to appear. No objection is made, however, to any statement or device required or permitted by the government indicating compliance with regulations of a government bureau or department. (3) If the seal is used in price lists and cata- logs which also feature unaccepted articles, it must be used for accepted articles in such a manner that there can be no impli- cation that the seal applies to the unaccepted articles. (4) The following statement in reference to the significance of the seal may be used in connection with the seal: "The 'accepted' seal denotes that [name of article] has been accepted for New and Nonofficial Remedies by the Council on Pharmacy and Chemistry of the American Medical Association." Further statements in regard to the seal must be submitted to the Council and found acceptable before they may be used. (5) The size of the seal on the package shall not be greater than one inch in height or diameter, and in advertising it shall be in proportion to the dimensions of the advertisement so as to afford ready recognition ; but undue size, giving greater promi- nence to the seal than to other important features of the adver- tisement or detracting from the dignity of the seal in the opinion of the Council, will not be permitted. (6) When for any reason the acceptance of an article is rescinded, the seal must not appear on new labels or in new advertising for such article ; and old labels and advertising which feature the seal must not be in circulation, in evidence, or before the public longer than six months subsequent to notification of the revocation. Duration of Acceptance. — Unless otherwise determined at the time of acceptance, articles admitted to New and Nonofficial OFFICIAL RULES OF THE COUNCIL 13 Remedies will be retained for a period of three years, provided that during that period they comply with the rules and regula- tions which were in force at the time of their acceptance. New evidence indicating that compliance with the rules no longer exists, for instance, with regard to unwarranted therapeutic claims, will be considered the basis for reconsidering the acceptance before the end of a period of three years. At the end of this period, all articles will be carefully reexamined for compliance with existing rules. Particular weight will be given to the question as to whether recent evidence has substantiated claims as to the therapeutic value of any preparation, this evi- dence to consist partly of recent statements in the literature and partly of the general esteem in which the preparation is held by clinical consultants of the Council. The reacceptance of articles after such reexamination shall be for three years unless a shorter period is specified. Any amendments to the rules, by specific requirements or by interpretation, which may be made after the acceptance of an article, shall not apply to such article until the period of acceptance has elapsed. At the end of this period the article, if it is not eligible under the amended rules, will be omitted. The Scope of New and Nonofficial Remedies. — To aid physicians and manufacturers in deciding which articles come within the scope of this book, or, in other words, to enable physicians to recognize whether an article which is not described in New and Nonofficial Remedies has not been included because it has been held not to come within the scope of N. N. R. or because it has been rejected, the Council furnishes the following more detailed definitions : Official Articles.— Articles official in the U. S. P. or N. F. are exempted from consideration by the Council if they are marketed under the official name or a name which makes their official status evident, and if no unestablished therapeutic claims are made for them. These do not require consideration by the Council, since standards for them are provided in these books, and enforced under the provisions of the federal Food and Drugs Act, except that they may be mentioned for information. If a U. S. P. or N. F. product is offered for sale under a name which does not make its official status evident, or if the proprietors or their agents advance claims that the product possesses therapeutic properties other than those properly accredited to it, it becomes subject to consideration by the Council. Simple preparations or mixtures of official articles may be considered to have the status of official articles if they are marketed under descriptive, nonproprietary names and if unes- tablished claims are not made for them. At the request of the distributors of such products the Council will determine whether they meet these provisions, and if they are found not to require 14 NEW AND NONOFFICIAL REMEDIES inclusion in N. N. R. they will be included in a list of articles and brands accepted by the Council but not described in N. N. R. Modifications of U. S. P. and N. F. Products. — A Pharma- copeial or National Formulary product which is marketed under the official title or synonym, but with well-founded claims that its purity, permanence, palatability or other physical properties excel the official standard, may, if no extraordinary therapeutic properties are asserted, be considered as an official article and held not to be within the scope of New and Nonofficial Remedies. When such products are marketed under the claim that they possess therapeutic properties other than those commonly accredited to the U. S. P. or N. F. products of which they are modifications, they become subject to the consideration of the Council. The burden of proof in establishing claims for therapeutic properties of products considered by the Council shall lie with the proprietor or, in the case of a foreign-made product, with the agent who markets the product in the United States. Substances Described in Nezv and Nonojficial Remedies. — In the book will be described simple proprietary substances and their preparations ; proprietary mixtures if they have originality or other important qualities which, in the judgment of the Council, entitle them to such place ; important nonproprietary nonofficial articles ; simple pharmaceutic preparations ; or any other article, the inclusion of which is believed to give useful information to the physician. An article will not be accepted or retained unless it is found in the open market under the name of the firm under which it is submitted or accepted. The term "open market" contemplates both the wholesale and retail mer- chandizing of drugs. Proprietary Mixtures. — A mixture will be considered as pro- prietary, and therefore requiring consideration by the Council for admission to the book, if it contains any proprietary articles, if it is marketed under a name which is in any way protected or if its manufacturer claims for it any unusual therapeutic qualities. Diagnostic Reagents. — Reagents and other drug preparations which are not used in or on the human body, and protein prepa- rations used for diagnosis only shall not be considered for inclusion in N. N. R. At the request of the distributor the Council will determine the status of such products individually, and if the product is found not to require inclusion in N. N. R. it will be included in a list of Articles and Brands Accepted by the Council but Not Described in N. N. R. Suffix N. N. R. — When nonproprietary articles included in New and Nonofficial Remedies are prescribed, the Council rec- ommends that they be indicated by the abbreviation "N. N. R.," OFFICIAL RULES OF THE COUNCIL 15 thus insuring to the prescriber the quahty of these articles laid down in the book. Rule 1. — Composition — Secrecy Objectionable. — It is not only the right but also the duty of the physician to know the essential composition of what he prescribes ; the Council cannot compromise on this proposition. Statement of Composition. — In the case of a definite "chem- ical substance, a descriptive name, satisfactory to the Council, must appear on the label and in the advertising. For mixtures, the label and advertising must contain a statement of the amount of each potent or important ingredient in a given quan- tity of the mixture. In the case of solutions marketed in the form of ampules the term ".. cc. size" will be accepted as a proper indication of the volume of contents, the significance of the term being understood to be that the ampule contains a suffi- cient excess of the medicament to permit the withdrawal and administration of the dosage indicated by the size denomina- tion. Individual ampules, or unit packages thereof, must bear a statement explaining the significance of the term ".. cc. size" as it applies in a given instance. For example, if ampules are labeled "2 cc. size," a satisfactory statement will be: "Each ampule contains a sufficient amount (or excess) to permit withdrawal and administration of 2 cc." Vehicles and Preservatives. — In the case of mixtures, not only the potent ingredient, but also the general character of the vehicle, the presence of alcohol and the identity of preserva- tives, or of any other substance, whether added or present as an impurity, must be stated if these can under any circumstances afifect the therapeutic action of the article. This, as a rule, does not mean the publication of trade secrets, such as flavors or the details of the working formula. Trade Secrets. — Furthermore, trade secrets will not be received as confidential by the Council, since it accepts infor- mation only with the distinct understanding that this may be freely published, at its discretion. Inspection of Factories. — The Council does not accept invi- tations to inspect factories ; its concern is with the finished products. On the other hand, the Council requires that the informa- tion be complete and accurate as to medicinal ingredients. Nonofficial Constituents. — Nonofficial constituents of proprie- tary mixtures must be presented by the manufacturer in the regular way and must be acted on by the Council before the preparations containing them can be accepted. Fraud. — When it appears that a manufacturer has made a delibei'ately false statement concerning a product, he is asked to furnish an explanation ; and if this is not satisfactory, the product will not be accepted, even if the false statement is subsequently corrected or omitted. 16 NEW AND NONOFFICIAL REMEDIES Testimonials. — The foregoing paragraph apphes not only to statements made to the Council, but also to statements fur- nished to physicians by the manufacturer or his agents, even when these statements are in the guise of testimonials. Rule 2. — Identification. — In order to avoid errors in the case of chemical compounds, and to guard against adultera- tions, . lack of potency or strength and the mistaking of one chemical for another, it is necessary to have at hand suitable tests. Tests, etc. — If these facts have appeared in the literature, or in standard textbooks, reference to them will be sufficient ; but with new chemicals, especially synthetics, the manufacturer or his representatives will be required to supply such tests for publication as will assure an intelligent opinion of these products. Physiologic Standardization. — In cases in which chemical methods of identification are unknown or unreliable, physio- logic standardization should be employed. The Council con- siders the phrase "physiologically standardized" or "assayed" as misleading unless the standard and method are published in sufficient detail to permit of their control by independent inves- tigators. It is evident that when no standard is published, it is impos- sible to know whether the quality is high or low, and the con- scientious manufacturer who sets for himself a high standard is placed on a level with the dishonest or careless one who adopts a low standard. Again, if the process of standardization is not published, it is impossible to learn, without actual trial, the relative value of one preparation as compared with that of another manufacturer or to confirm or disprove the statements of the manufacturer as to the quality of his product. Standardisation of Disinfectants and Germicides. — No disin- fectant or germicide of the phenol type will be accepted for inclusion in New and Nonofficial Remedies whose phenol coefficient, determined by the U. S. Food and Drug Administra- tion method of testing antiseptics and disinfectants, as given in Circular No. 198, U. S. Dept. of Agriculture, is not stated on the label of the preparation. Rule 3. — Direct Advertising. — Lay Advertising. — The impossibility of controlling the irresponsible claims which arc usually made in advertisements to the public, the well-known dangers of suggesting by descriptions of symptoms to the minds of the people that they are suffering from the many diseases described, the dangers of the unconscious and innocent forma- tion of a drug habit, and the evils of harmful self-medication, including the dangers of the spread of many infections and contagious diseases when hidden from the physician, and similar well-known considerations, are the reasons for discouraging, in the interest, and for the safety, of the public, this repre- hensible form of exploitation. Advertising in medical journals, and other publications distributed solely to physicians, or in OFFICIAL RULES OF THE COUNCIL 17 journals for dentists, pharmacists, nurses and veterinarians, does not come within the scope of this rule, provided such advertis- ing does not invite or encourage use by unqualified persons. Exceptions. — In the case of subjects on which the public should be instructed, as in the use of certain disinfectants, germicides, antiseptics, laxatives and such other articles as the Council may specify, advertisements to the public, if not in objectionable forms, are considered admissible. In no case shall such advertisements include recommendations for use as curative agents, nor shall the names of any diseases appear on or in the trade package, except in connection with prophylactic recommendations. ■ If the preparation is sufificiently toxic to require caution in its use to prevent poisoning, this fact shall be stated on the label. On account of the deplorable results which would follow any abuse of this privilege the con- scientious cooperation of manufacturers and their agents in adhering strictly to the limitations laid down is asked; and for the same reason the acceptance of an article which is so advertised as to infringe on these limitations in any essential way (as by naming diseases or by making false and exaggerated claims) shall be summarily rescinded, and the reasons for such action may be published without notice to manufacturer or agent. A disinfectant, germicide or antiseptic will be accepted for description in New and Nonofficial Remedies, and an article of this class which has already been accepted will continue to be included in New and Nonofficial Remedies only on the explicit understanding by the manufacturer and agent that such infringements of the rule will be followed by deletion of the article and by publication of the facts as described. Advertisements in Foreign Countries. — The Council deals primarily, in the interest of the public and of the medical pro- fession, with articles proposed for admission to New and Non- official Remedies, and, in determining the status of any article, must take into consideration any statements made regarding it or any method of advertising it employed by the manufacturer or his authorized agents or representatives, whether in this country or abroad. The Council will not regard as within its scope, however, questions concerning the marketing of articles (except the matter of direct advertising to the laity and unwar- ranted claims or misrepresentations) outside the United States. Rule 4. — Indirect Advertising. — It should be remembered that the sole intent of this rule is to protect the physician, so that in prescribing a proprietary medicine he shall not uncon- sciously advertise proprietary preparations. The rule imposes no restriction on the legitimate methods of bringing a remedy to the attention of the profession, such as advertising in medical journals, circulars and other printed matter distributed solely to physicians. The rule applies only to the package as it may reach the patient. Naming Diseases on Label. — The naming of diseases on the label or package is not necessary, as is shown by the very 18 NEW AND NONOFFICIAL REMEDIES large number of proprietary products which have been success- fully introduced without resorting to this expedient. This method of popularizing a proprietary remedy with the laity is most objectionable, and should not be tolerated in any form. Therapeutic Indications. — In general, therapeutic indications should be omitted from the label and package. The Council will not insist on this point, however, when such indications are so given as not to promote self-medication, particularly in diseases which require expert diagnosis and supervision. Permanently Affixed Names. — It will be considered an infringement of the rule if an article is marketed in bottles which have the name of the article blown into the glass, or if otherwise the name or initials or other distinctive mark of the article is permanently stamped on the container, on the article itself, or is on the stoppers or seals. Articles which are marketed in any of these ways are not accepted for New and Nonofficial Remedies. Readily removable labels are not objec- tionable nor is the permanent affixing of the firm's initials or name to the trade package if such initials or name is not sug- gestive of the article. Use of Articles for Advertising. — The Council does not coun- tenance the use of an accepted article for advertising other articles which have not been accepted by the Council, nor the inclusion of advertisements for accepted articles in packages of nonaccepted products ; this applies to circular matter dealing with such accepted articles whether included with the trade packages or otherwise, but does not apply to price lists and catalogues. Nor will the Council accept an article or continue the acceptance of an article if the same article or an essentially similar one is marketed by the same firm under another name which has not been recognized. When, in the opinion of the Council, a firm secures the acceptance of one or more articles and employs the acceptance in a way that promotes the exploitation of articles that are opposed to the principles of the rules of the Council, the preparations of the firm will be dismissed summarily and no preparations of that firm will be accepted by the Council. Rule 5. — False Claims as to Origin. — No false or mis- leading statement in regard to an article can be permitted con- cerning the source or material from which it is made, or the persons by whom it is made. Some glaring frauds of this nature have been perpetrated in the past, and this rule is intended to prevent such imposition. Rule 6. — Unwarranted Therapeutic Claims. — This rule insists that the claims of manufacturers or agents concerning the therapeutic properties of their products must be compatible with demonstrable facts. Manufacturers will be held respon- sible for all statements made or quoted in their advertising ''literature" regarding their products. The use of the personal signature of a physician, or the facsimile of such signature on the label, or in advertising of products is objectionable because OFFICIAL RULES OF THE COUNCIL 19 it tends to create, through the implication of personal super- vision, an exaggerated or misleading impression of therapeutic value, and articles so labeled or advertised are therefore not acceptable. Therapeutic claims made subsequent to the accept- ance of an article must be submitted to the Council for review, provided such claims exceed, or substantially modify, those made at the time of acceptance. Recognizing the existence of honest differences of opinion on many therapeutic questions, the Council desires to be liberal in the application of this rule. It is natural that a manufacturer should be partial toward his own product, and a moderate degree of emphasis in advertising ma}' not be objectionable. The Council, how- ever, will not admit claims which are neither in harmonv with already accepted facts nor supported by acceptable evidence. In doubtful cases the Council considers these questions with the advice and cooperation of its staff of clinical consultants. Therapeutic claims that do not exceed the statements in the current New and Nonofficial Remedies will not be challenged as a rule; but if the Council finds reason to doubt the validity of any description in New and Nonofficial Remedies, it may require the manufacturer to submit further evidence if he desires to continue such claims. Since the claims of the manufacturers are judged largeFy by their advertising, noncompliance of the manufacturers with the Council's request for copies of the cur- rent advertising may be sufficient ground for the rejection of an article, unless in individual cases the Council deems such submission unnecessary. The Council holds that the terms "advertising" and "advertising literature" include films and similar devices for informing the public or the profession. Clinical Evidence. — To be acceptable, the clinical evidence must offer objective data with such citation of authority as will enable the Council to confirm the facts and establish the scientific value of the conclusions drawn. The amount and character of the evidence which is required depends on the inherent probability of the claims : No evidence is needed for a self-evident claim ; very strong evidence is needed when the claim is contrary to the accepted data of science. The accepta- bility of evidence is determined mainly by its quality. The mere multiplication of inaccurate observations does not render them accurate. The evidence must be furnished in sufficient detail to permit judgment as to the care with which it was gathered and the legitimacy of the deductions. Comparative trials facilitate and are often necessary for such judgment. Observations that are not described with sufficient detail to permit verification are subject to suspicion. The credibility of the data and the justification of the deductions is influenced by the reputation and experience of the investigators, as to disin- terestedness, technical ability and critical sense. Anonymous communications and observations gathered without adequate facilities are usually worthless as evidence. 20 NEW AND NONOFFICIAL REMEDIES Rule 7. — Poisonous Substances. — For the information of the pharmacist or dispenser, and to enable him to safeguard the interests of the patient and the physician, all articles con- taining such potent agents as the poisonous alkaloids and other organic substances and the salts of some of the metals should have the exact amount of these ingredients which is contained in the average adult dose stated on the label. Rule 8. — Objectionable Names. — Many of the abuses con- nected with proprietary medicines arise from "coined" pro- prietary trade names. Such names will not be recognized by the Council unless in particular instances the Council j-hall deem their use to be in the interest of public welfare. In every such exception the burden of proof, both for establish- ing and for continuing the exception, lies with those who market the product. Proprietary ("Trade") Names; When Permitted. — In con- sideration of the benefits which may come from the discovery of a therapeutic agent, the Council concedes to the person or firm which, by right of discovery, controls such a product the right to name it. The Council will offer no opposition to an arbitrary name for such a new product, provided it is not misleading, therapeutically suggestive or otherwise subversive of scientific pharmacy and therapeutics. If the discovery that a previously known substance has therapeutic value is deemed of sufificient importance, the Council may recognize a name for such a substance if the name is applied by the person who makes the discovery; or, with the consent of the discoverer or in the absence of any protest on his part, the Council may recognize a name applied by the firm which first makes such a product available to physicians. Under these conditions the Council may also recognize proprietary names when new uses or actions of exceptional novelty and importance are discovered for substances previously used in medicine, but which had become practically obsolete. In the interest of rational drug therapy, the Council recommends that trade names be coined so as to indicate the potent element or constituent. Since the use of numeral or alphabetical designations in connection with drug names tends to take the emphasis away from the name and to displace the name, thus leading to confusion, the Council will not recognize the name of a drug in which the numeral or letter is an integral part of the name, except in special cases in which the use of a numeral or letter seems desirable because further improvement of the product is anticipated, in which case the Council may grant a special exemption from the rule. Under this rule the use of numerals or letters in connection with the name of a product will not be permitted on labels or in advertising, unless the numeral or letter is clearly separated from and subordinated to the name by type, and if feasible by position. This rule shall not apply to price lists and catalogs. When the proprietary or trade name for an article is con- sidered insufficiently descriptive of its chemical composition or OFFICIAL RULES OF THE" COUNCIL 21 pharmaceutic character, the Council may require as a condi- tion for the acceptance of such articles that a descriptive scientific name satisfactory to the Council appear on the labels, circulars and advertisements for such an article. For all defi- nite chemical substances it is required that the scientific (chemical) name be given prominence on the labels, in circulars and in advertisements ; provided that for those substances for which there are recognized Council or pharmacopeial names, such names shall be used and the scientific (chemical) name need not appear. Proprietary Names for Unoriguml Articles. — Proprietary names will not be recognized for articles which are included in the U. S. Pharmacopeia or National Formulary or for articles which are already accepted in New and Nonofficial Remedies or for unessential modifications of such articles. Neither will pro- prietary names be recognized for substances or mixtures which are described in medical or pharmaceutic publications, except in connection with fundamentally important discoveries relating to articles the use of which had become practically obsolete. In the marketing of unoriginal articles, the legitimate inter- ests of the producer are fully served by identifying such prod- ucts by appending the name or initials of the manufacturer or agent, or by the use of a general brand mark. No objection will be made by the Council to the use of such brand marks, provided that in no case shall such mark be used as a designa- tion for an individual article. Names, initials or brand marks of manufacturers or agents when used to denote proprietorship shall not be of such character as to cause any misunderstanding or confusion as to their significance. For any product which, by reason of the absence or lapse of patent rights or for other reasons, is open to manufacture by more than one firm, the Council reserves the right to select a common name and to provide standards of identity, purity and strength. The Council then will accept such article only if it is marketed under the title adopted as the N. N. R. name or the name under which such article was introduced (to which may be appended the firm's identifying mark). When an article which has been accepted for New and Non- official Remedies is admitted to the U. S. Pharmacopeia or National Formulary, it will be omitted from New and Non- official Remedies one year after such standardization if the name of such article is used in these standards either as the main title for the product or as a synonym. If the name under which the article is described in New and Nonofficial Remedies is not used in these books of standards, the pro- prietary preparation will be retained provided the official name is given prominence on the labels and in the circulars and advertisements of such article. When the Council adopts a common name for an article that has been admitted under another name, it will be con- 22 NEW AND NONOFFICIAL REMEDIES tinued under the older name only on condition that the Council name be given prominence on the label and in the circulars and advertisements for such article. Pharmaceutic Preparations and Mixtures. — These, with rare exceptions, are not original in composition and should not be endowed with uninforming names. It is important that they be so named as to remind the prescriber constantly of their potent ingredients. When, in the rare exception, a pharma- ceutic preparation or mixture is accepted with a coined name on the ground of originality because it presents a distinct improvement over available preparations, only the first prepa- ration of this kind which is placed on the market shall be recognized under a coined name (which, however, must clearly indicate the potent constituent of the preparation). The Coun- cil may also recognize coined names for pharmaceutic prepara- tions or mixtures that were in actual use before the establishment of the Council and that have been used continuously since that time, and names for mixtures that were named under the reasonably justified bona fide belief that they were chemical compounds, provided that such coined names indicate the potent ingredient or ingredients of the preparation, are not misleading, and do not suggest diseases, pathologic conditions or therapeutic indications. Difficulty frequently arises from the application of coined names to salts. For example, a firm introduces the hydro- chloride of a synthetic base under the name "Artificialin." Subsequently the firm decides to introduce the lactate of the same base. If this is called "Artificialin lactate" the name "Artificialin" will now mean the base instead of the hydro- chloride which is being marketed under that name. In order to avoid this confusion the Council holds that coined names for salts will not be accepted unless such names indicate the com- ponents of such salts, thus "Artificialin hydrochloride" ; the name "Artificialin," unqualified, is acceptable only for the base. A similar difficulty may arise when a product is marketed first only as a pharmaceutic preparation to which the manufacturer wishes to apply a short coined name, for example, an elixir of a new hypnotic under the name "Aliphal." If later, the manu- facturer elects to market the substance also in powder form, an entirely new name would become necessary and this would cause confusion both to the profession and to the trade. The Council therefore holds that coined names for new substances marketed as pharmaceutic preparations will not be accepted unless such names indicate the type or dosage form of the preparation; thus "Elixir of Aliphal," "Aliphal Powder," not "Aliphal" unqualified. Mineral Waters. — The commercial names of natural mineral waters will be accepted, provided that they are not misleading, therapeutically suggestive or otherwise objectionable. Therapeutically Suggestive Names. — Names which carry the suggestion of a therapeutic indication, pathologic condition, dis- OFFICIAL RULES OF THE COUNCIL 23 ease or organism causing a disease shall be considered thera- peutically suggestive. Articles bearing such names will not be accepted for New and Nonofficial Remedies, first, because they are likely to lead physicians into prescribing names instead of remedies, and second, because they tend to encourage unwar- ranted self-medication by the laity. Even if the name is at first apparently meaningless to the public, its meaning will soon be understood because patients soon learn the technical names applied to their diseases and symptoms. The prohibition against therapeutically suggestive names is not applied to serums, vaccines and antitoxins, because the accepted nomenclature of the specific organisms used in their preparation makes this unavoidable and because self-medication with them is improbable. Rule 9. — Patents, Trademarks, Copyrights, Etc. — This information is important as a means of determining the legal status of medicinal articles and as an aid to their ready recog- nition in current publications. Rule 10. — Unscientific and Useless Articles. — The use of articles which are unessential modifications of official or established nonproprietary articles is unscientific and serves no useful purpose. The Council will not accept products which are scientifically unsound and which, therefore, must be con- sidered useless or inimical to the best interests of the medical profession and the public. This class includes compounds or mixtures containing an excessive number of active ingredients ; those compounds or mixtures the components of which are of no probable assistance to one another, and those articles which are of no therapeutic value. Unessential Modefications of Official Substances. — Imitations. — The subterfuge of obtaining proprietary rights over an official or established nonproprietary product by introducing unessential modifications also tends to confusion and abuses. and such articles will not be admitted by the Council. Essential and important modifications, however, will receive recognition. (The Council interprets the term "established nonproprietary product" as applying to a preparation of any formula which has been published through any recognized or reasonably acces- sible channel of publication, prior to its appropriation or modification by a manufacturer.) Duplicates of biologic prod- ucts accepted under the names of the manufacturers will not be accepted under the names of the distributors. Rule 11. — Policies of Firms Detrimental to Rational Therapeutics. — The evidence on which the Council may refuse recognition to the products of a firm shall be: (1) the fact that but a small proportion of the firm's proprietary products are acceptable for New and Nonofficial Remedies ; (2) that a large proportion of the business of the firm is in products 24 NEW AND NONOFFICIAL REMEDIES that are in conflict with the rules of the Council ; (3) that physicians who reply to the firm's advertisements of accepted products are supplied with advertising which features the use of products that are in conflict with the Rules of the Council, or (4) that the firm makes claims that are seriously misleading, especially if these claims tend to promote the use of products in any manner that would seriously endanger public health. NEW AND NONOFFICIAL REMEDIES AGAR AND AGAR PREPARATIONS AGAR. — Agar-Agar. — "The dried mucilaginous substance extracted from Gclidmm corneiim (Hudson) Lamouroux and other species of Gclidmm (Fam. GeUdiaceae) and closely related algae (Class Rhodophyccac). Agar contains not more than 1 per cent of foreign organic matter, and yields not more than 1 per cent of acid-insoluble ash, and not more than 18 per cent of moisture."-U. S. P. For standards see the U. S. Pharmacopeia under Agar. Agar Agar-Merck. — A brand of agar-U. S. P. Prepared by Merck & Co., Railway, N. J. Agar Agar Powder-Merck. Agar Agar Shreds-Merck. Agar-Agar Shreds-Reinschild. — A brand of agar-U. S. P. Prepared by Reinschild Chemical Co., New Roclielle, N. Y. PHENOLPHTHALEIN-AGAR.— Agar impregnated with phenolphthalein, 100 Gm. containing 3 Gm. of phenolphthalein. Actions and Uses. — Phenolphthalein-agar is claimed to have the properties of agar augmented by the action of phenol- phthalein. Dosage. — 1 Gm, (15 grains), twice daily, after breakfast and supper, increased or diminished according to requirements. Manufactured by The Reinschild Chemical Company, New Rochelle, New York, U. S. patent 943,163 (Dec. 14, 1909, expired). No U. S. trademark. Phenolphthalein-agar is prepared by impregnating 1,000 Gm. of agar with a solution obtained by dissolving 30 Gm. of phenolphthalein in a mixture of 2,000 cc. of water and 700 cc. of alcohol and slowly drying the impregnated agar. ALLERGENIC PROTEIN PREPARATIONS Allergenic protein preparations are extracts prepared from the proteins of various substances believed to be responsible for sensitization of patients suffering from various affections. These preparations are used for diagnosis, prophylaxis or desensitization in conditions due to hypersensitiveness (allergy). They are made from the proteins of pollens believed to be the cause of hay-fever ; from the proteins obtained from the hair or epidermis of animals or the feathers of fowls ; from the purified proteins of various biologically reactive foods ; from the proteins extracted from bacterial cells, and from proteins derived from other sources and believed to be respon- sible for cases of allergy. In general, only proteins from a single source are accepted — that is, from a single species if an 26 NEW AND NONOFFICIAL REMEDIES extract from the pollen of plants, the hair or epidermis of animals or the feathers of fowls is employed; from a single strain of bacteria, or from a single food. However, the Council has accepted extracts of grass or ragweed mixtures or mixtures of other closely related pollens when their use has appeared rational. Practically all observers agree that the majority of cases of hay fever may be traced to the pollens from the following sources : timothy, which is the cause of spring hay fever in the East ; certain grasses which are the causes of spring hay fever in the Middle West, and ragweed, which is the common cause of autumn hay fever throughout the Middle West and the East. For practical purposes, in the East, at least 90 per cent of the patients can be treated by two extracts alone. In the other cases, the sensitiveness of the patient must be determined by a series of tests with pollens indigenous to the locality in which the patient lives. It is often more convenient and satis- factory to prepare extemporaneously the pollen or the epi- dermal extracts to meet the needs of the individual case. Since liquid pollen and epidermal extracts deteriorate with age, it is necessary, in order to insure their potency, that they be used before the expiration of a given time (determined by the regulations of the U. S. Treasury Department). Pollen extracts containing at least 50 per cent of glycerin should be used within two years of the date of their preparation, while those containing less glycerin or which are supplied in aqueous saline solutions should be used within one year of the date of preparation. Alcoholic epidermal extracts should be used within two years of the date of their preparation, while aqueous extracts should be employed within one year of the date of their preparation. All pollen and epidermal extract prepara- tions should be kept at low temperature. Attention is called to the fact that, even under these circumstances, extracts in high dilutions are more liable to deterioration than more con- centrated solutions. To insure sterility, the Council requires that liquid extracts intended for purposes other than diagnostic shall be put up in such a way as to avoid contamination and that their sale shall be authorized by the U. S. Treasury Department under the law governing the sale of biologic products. The Council requires that the identity of any pre- servative used in accepted allergenic protein preparations be declared on the label. Actions and Uses. — Pollen extract is employed for the diag- nosis, prophylaxis, or relief of a common type of hay fever — pollinosis. A pollen extract prepared from the pollen of one plant is not intended for use in pollinosis caused by the pollen from other plants, though persons suffering from hay fever frequently react to the pollen of more than one species. The patient's susceptibility may be tested by rubbing a small quantity of the pollen extraci into a scratch of the skin ; if the patient is sensitive to that particular pollen, an urticarial wheal ALLERGENIC PROTEIN PREPARATIONS 27 results. To avoid systemic disturbance, it is recommended that no therapeutic injections be made until the reaction from this cutaneous test has subsided completely. When treatment with pollen extract is carefully and systematically pursued, it gives complete relief from symptoms in a few instances and consider- able relief from symptoms in a large proportion of cases, and fails to give any relief in a small number of cases. The immunity from symptoms resulting from treatment is apparently not permanent, and in most cases does not last longer than a year. Epidermic protein extracts are employed for the diagnosis and relief of asthma or perennial rhinitis. The patient's sus- ceptibility may be tested in the same manner as with the pollen extracts. Therapeutic injections have been employed in an attempt to relieve the paroxysms of asthma, but the results of treatment have not seemed so satisfactory or so lasting as those obtained from the use of pollen extracts in hay fever. The food protein extracts are used in cases in which persons show a peculiar hypersensitiveness toward certain articles of the dietary. Their purpose is twofold : to identify the food which produces the untoward symptoms, and, to a lesser extent, to immunize the patient by their proper application against the ill effect of this food. The bacterial protein extracts are used cutaneously for the diagnosis of anaphylaxis to the metabolic products from specific bacteria. Their utility is debatable. In order that the number of skin tests to determine sensi- tiveness to proteins may be reduced, it has been proposed to employ mixtures of protein preparations, and if sensitiveness to a given mixture is found, then to make tests with the indi- vidual proteins contained in this mixture. There is the objec- tion to this procedure that with patients who react very slightly to one member of a mixture, the dilution which has occurred on account of the presence of other proteins may render a reaction negative. On the ot-lier hand, if a patient is highly sensitive to all the proteins of a mixture, cutaneous reactions may give rise to systemic disturbances. Dosage. — It is regarded as important that the individual dosage be determined by testing each patient's susceptibility to the specific protein extract, as sensitiveness varies greatly and an overdose may cause disagreeable or alarming symptoms or even death. A method used for such a test is to make a series of scratches on the patient's skin (it is important that these should be made at some distance from the scratches of the first test) and to apply to these scratches 25 per cent, 10 per cent, 1 per cent, or even weaker dilutions of the protein extract. From 2 to 5 drops of the dilution which fails to produce a definite skin reaction may be injected subcutaneously as the first dose. Injections, increased by a few drops at first, and later by the use of a stronger dilution, may then be given at intervals of a few days or a week. 28 NEW AND NONOFFICIAL REMEDIES Owing to the relative insolubility of most of the food pro- tein preparations and the difficulty of preparing them in sterile form, they cannot with safety be injected intradermally, and, therefore, the tests for hypersensitiveness must be made by the cutaneous or scarification method. The intensity of the reaction will depend somewhat on the concentration of the protein solu- tion. No systemic effect should be produced. When the identity of the particular food protein causing the symptoms is thus established, it has been found that the patient may be desensitized by the administration of gradually increas- ing amounts of food containing the offending protein or of the isolated food protein itself. If the isolated food proteins are used, they are best administered mixed with the ordinary foods. The dose at first should not exceed from 0.005 Gm. to 0.01 Gm., and, in highly sensitive individuals and children, it is best to start with a dose not larger than from 0.0005 Gm. to 0.001 Gm. In some cases, the skin reaction serves as an indication of the effect being produced by the dosage employed. Occasionally, the skin reaction decreases in intensity or disappears as the dosage is increased, but, in most instances, the skin reaction persists even though the patient is able to withstand fair amounts of the food to which he had previously been sensitive. The efficiency of the treatment can be judged by the patient's ability to ingest, without ill effects, large quantities of the food protein which previously produced the untoward symptoms. Simple Protein Preparations ALLERGENIC EXTRACTS-LEDERLE. — Liquids obtained by extracting the protein of substances believed to be the cause of specific sensitization. Actions and Uses. — See preceding article, Allergenic Protein Preparations. Dosage. — See preceding article,' Allergenic Protein Prepara- tions. Allergenic Extracts-Lederle are marketed in 6 cc. vials. Manufactured by the Lederle Laboratories, Inc., Pearl River, N. Y. No U. S. patent or trademark. Undiluted Extracts: Alfalfa Allergenic Extract-Lederle^ ; Apple Allergenic Extract-Lederle ^; Apricot Allergenic Extract-Lederle ^ ; Black- berry Allergenic Extract-Lederle ^; Blueberry Allergenic Extract-Lederle "; Cantaloupe Allergenic Extract-Lederle ^; Cherry Allergenic Extract- Lederle ■*; Cranberry Allergenic Extract-Lederle ^ ; Currant (Red) Aller- genic Extract-Lederle ^; Date Allergenic Extract-Lederle ^ ; Fig Allergenic Extract-Lederle ^; Gooseberry Allergenic Extract-Lederle °; Grape Aller- genic Extract-Lederle ^; Grapefruit Juice Allergenic Extract-Lederle ^; Grapefruit Peel Allergenic Extract-Lederle ^ ; Huckleberry Allergenic Extract-Lederle^; Juniper Berry Allergenic Extract-Lederle^ ; Lemon Juice Allergenic Extract-Lederle ^; Lemon Peel Allergenic Extract- Lederle S; Lime Allergenic Extract-Lederle "; Melon (Honey Dew) Aller- genic Extract-Lederle ^ ; Melon (Casaba) Allergenic Extract-Lederle ^; Peach Allergenic Extract-Lederle^; Peach Skin Allergenic Extract- Lederle^; Pear Allergenic Extract-Lederle^; Pineapple Allergenic Extract- Lederle^; Plum Allergenic Extract-Lederle^; Pomegranate Allergenic Extract-Lederle'^ : Prune Allergenic Extract-Lederle^; Quince Allergenic ALLERGENIC PROTEIN PREPARATIONS 29 Extract-Lederls ^; Raisin Allergenic Extract-Lederle ^; Raspberry (Red) Allergenic Extract-Lederle^; Rhubarb Allergenic Extract-Lederle^; Straw- berry Allergenic Extract-Lederle^; Tangerine Allergenic Extract-Lederle^; Watermelon Allergenic Extract-Lederle.^ Undiluted and 1:10 Dilution: Alligator Pear Allergenic Extract- Lederle^; Allspice Allergenic Extract-Lederle^; Anchovy Allergenic Extract-Lederle^; Artichoke Allergenic Extract-Lederle^; Artichoke (Jerusalem) Allergenic Extract-Lederle *; Asparagus Allergenic Extract- Lederle '"; Banana Allergenic Extract-Lederle '; Barley Allergenic Extract- Lederle 2; Bass Allergenic Extract-Lederle ^; Bay Leaf Allergenic Extract- Lederle '; Bean (Kidney) Allergenic Extract-Lederle ^; Bean (Mexican) Allergenic Extract-Lederle-; Bean (Naz-y) Allergenic Extract-Lederle-; Bean (Pea) Allergenic Extract-Lederle -; Bean (String) Allergenic Extract- Lederle ^; Beef Allergenic Extract-Lederle ^ ; Beet Allergenic Extract- Lederle ^ ; Bluefish Allergenic Extract-Lederle ^ ; Broccoli Allergenic Extract-Lederle^; Brussels Sprouts Allergenic Extract-Lederle ^; Butter- fish Allergenic Extract-Lederle *; Cabbage Allergenic Extract-Lederle ^ Carp Allergenic Extract-Lederle^; Carrot Allergenic Extract-Lederle^; Catfish Allergenic Extract-Lederle^; Cauliflower Allergenic Extract- Lederle ^; Caviar Allergenic Extract-Lederle -; Celery Allergenic Extract- Lederle^^; Chicken Meat Allergenic Extract-Lederle^; Chicory Allergenic Extract-Lederle ^; Chive Allergenic Extract-Lederle '; Cinnamon Allergenic Extract-Lederle^; Citron Allergenic Extract-Lederle^; Clam Allergenic Extract-Lederle'^; Clove Allergenic Extract-Lederle''' ; Codfish Allergenic Extract-Lederle ^ ; Coffee Bean Allergenic Extract-Lederle ^; Coinmeal Allergenic Extract-Lederle^; Corn (Sweet) Allergenic Extract-Lederle ^; Cucumber Allergenic Extract-Lederle ^; Dandelion Allergenic Extract- Lederle ''; Deer Meat Allergenic Extract-Lederle ^; Dill Leaves Allergenic Extract-Lederle'' ; Duck Meat Allergenic Extract-Lederle^; Eel Allergenic Extract-Lederle^; Egg Plant Allergenic Extract-Lederle ^; Endive Aller- genic Extract-Lederle^; Flounder Allergenic Extract-Lederle'^; Fluke Allergenic Extract-Lederle'-^; Frog's Legs Allergenic Extract-Lederle^ Gar- lic Allergenic Extract-Lederle ^ ; Ginger Allergenic Extract-Lederle "; Goat Meat Allergenic Extract-Lederle^; Goat Milk Allergenic Extract-Lederle*^; Goose Meat Allergenic Extract-Lederle ^ ; Green Pea Allergenic Extract- Lederle 2; Guinea Hen Meat Allergenic Extract-Lederle ^; Haddock Aller- genic Extract-Lederle ^; Halibut Allergenic Extract-Lederle ^ ; Henna Allergenic Extract-Lederle'^; Herring Allergenic Extract-Lederle^ ; Hops Allergenic Extract-Lederle''; Horse Meat Allergenic Extract-Lederle'"; Horseradish Allergenic Extract-Lederle ^; Horse Serum Allergenic Extract Lederle^; House Dust (New York Apartment .House) Allergenic Extract-Lederle "; Kale Allergenic Extract-Lederle ^^ ; Lamb Allergenic Extract-Lederle ^; Leek Allergenic Extract-Lederle ^; Lentil Allergenic Extract-Lederle ^; Lettuce Allergenic Extract-Lederle ^; Lima Bean Allergenic Extract-Lederle ^; Lobster Allergenic Extract- Lederle 2; Mace Allergenic Extract-Lederle ^ ; Mackerel Allergenic Extract-Lederle ^; Milk Allergenic Extract-Lederle *; Mushroom Aller- genic Extract-Lederle ^; Nutmeg Allergenic Extract-Lederle *; Oat (Meal) Allergenic Extract-Lederle ^; Okra Allergenic Extract-Lederle *; Olive Allergenic Extract-Lederle ^ ; Onion Allergenic Extract-Lederle '' ; Orange Allergenic Extract-Lederle ^; Oyster Allergenic Extract-Lederle ^; Oyster Plant Allergenic Extract-Lederle "; Paprika Allergenic Extract- Lederle^; Parsley Allergenic Extract-Lederle^; Parsnip Allergenic Extract- Lederle ^; Pea (Black-Eyed) Allergenic Extract-Lederle ^; Pepper (Green) Allerffenic Extract-Lederle^; Peppermint Allergenic Extract-Lederle'' ; Perch Allergenic Extract-Lederle^; Pickerel Allergenic Extract-Lederle^; Pike Allergenic Extract-Lederle^; Pompano Allergenic Extract-Lederle^; Pork Allergenic Extract-Lederle^; Potato (Sweet) Allergenic Extract- Lederle ^; Pumpkin Allergenic Extract-Lederle ^; Pyrethrum Allergenic Extract-Lederle'' ; Quail Allergenic Extract-Lederle^; Rabbit Meat Aller- genic Extract-Lederle ^ ; Rabbit Serum Allergenic Extract-Lederle ®; Radish Allergenic Extract-Lederle ^; Rice Allergenic Extract-Lederle ^; Rye Allergenic Extract-Lederle ^; Sage Allergenic Extract-Lederle '' ; Salmon Allergenic Extract-Lederle^; Sardine Allergenic Extract-Lederle ^ ; Scallion Allergenic Extract-Lederle^; Scallop Allergenic Extract-Lederle*; Senna Allergenic Extract-Lederle'' ; Shad Allergenic Extract-Lederle^; Shad Roe Allergenic Extract-Lederle^ ; Shrimp Allergenic Extract-Lederle^: Smelt Allergenic Extract-Lederle^ ; Sole Allergenic Extract-Lederle^ ; Soy 30 NEW AND NONOFFICIAL REMEDIES Bean Allergenic Extract-Lederle - ; Spinach Allergenic E.vtract-Lederle ^ ; Squab Allergenic Extract-Lederle'^; Squash Allergenic Extract-Lederle^; Squid Allergenic Extract-Lederle^; Sturgeon Allergenic Extract-Lederle''^; Sugar Cane Allergenic Extract-Lederle °; Szmss Chard Allergenic Extract- Lederle 5; Tapioca Allergenic Extract-Lederle -; Tea Leaf Allergenic Extract-Lederle "; Terrapin Allergenic Extract-Lederle ^ Thyme Allergenic Extract-Lederle ^; Tobacco Allergenic Extract-Lederle "' ; Tomato Aller- genic Extract-Lederle^; Trout (Lake) Allergenic Extract-Lederle^ ; Trout (Sea) Allergenic Extract-Lederle ^ ; Tuna Fish Allergenic Extract- Lederle^; Turkey Meat Allergenic Extract-Lederle^; Turnip Allergenic Extract-Lederle ^; Vanilla Allergenic Extract-Lederle'' ; Watercress Allergenic Extract-Lederle ^; Weakfish Allergenic Extract-Lederle^; Wheat Allergenic Extract-Lederle-; Whitefish Allergenic Extract-Lederle " : White Potato Allergenic Extract-Lederle '" ; Whiting (Fish) Allergenic Extract-Lederle.^ Marketed in vials containing, respectively 6 cc. of undiluted and diluted 1: 10 extract of New York apartment house dust. Undiluted, 1: 10 dilu- tion and 1: 100 dilution: Horse Serum Allergenic Extract-Lederle.^ 0.5 mg. of nitrogen per cc. and 0.05 mg. of nitrogen per cc: Chocolate Allergenic Extract-Lederle.'^ 0.2 mg. of nitrogen per cc. and 0.1 mg. of nitrogen per cc: Sheep Dander Allergenic Extract-Lederle.* 0.2. 0.1, 0.01, and 0.001 mg. of nitrogen per cc. : Horse Dander Allergenic Extract-Lederle * Orris Allergenic Extract-Lederle.'' 0.2 and 0.01 mg. of nitrogen per cc. : Cow Dander Allergenic E.rtract-Lederle* 0.2, 0.01, and 0.001 mg. of nitrogen per cc: Flaxseed Allergenic Extract-Lederle.^ 0.2 and 0.001 mg. of nitrogen per cc: Cottonseed Allergenic Extract-Lederle.^ 0.1 mg. of nitrogen per cc. : Feathers Allergenic Extract-Lederle.'^ Goat Dander Allergenic Extract-Lederle.* 0.1 and 0.01 mg. of nitrogen per cc: Bnckivheat Allergenic Extract-Lederle.'- 0.1 and 0.005 mg. of nitrogen per cc: Almond Allergenic Extract-Lederle,'* Peanut Allergenic Extract- Lederle.'^ 0.1 and 0.001 mg. of nitrogen per cc. : Dog Dander Allergenic Extract-Lederle * Egg JVhite Allergenic Extract-Lederle,^ Kapok Aller- genic Extract-Lederle,^ Mustard Allergenic Extract-Lederle. '•* 0.05 and 0.001 mg. of nitrogen per cc. : Cat Dander Allergenic Extract-Lederle,^ Rabbit Dander Allergenic Extract-Lederle.* 0.0005 mg., 0.005 mg., and 0.2 mg. of nitrogen per cc: Fish Glue Allergenic Extract-Lederle.^'' 1:10 Dilutions: Cow Serum Allergenic Extract-Lederle^; Jack Bean Allergenic Extract-Lederle.'' Products marketed in dilutions representing 1 mg. and 0.001 mg. of nitrogen per cc. : Silk (Silkzvorm) Allergenic Extract-Lederle.^'-^ Products marketed in dilutions representing 0.2, 0.1 and 0.001 mg. of nitrogen per cc. : Millet Seed Allergenic Extract-Lederle^ ; Mule Dander Allergenic Extract-Lederle.* Products marketed in dilutions representing 0.2 mg. and 0.001 mg. of nitrogen per cc: Anise Seed Allergenic Extract-Lederle^; Canary Seed Allergenic Extract-Lederle.^ Products marketed in dilutions representing 0.1 mg. of nitrogen per cc: Canary Dander Allergenic Extract-Lederle*; Chicken Feathers Allergenic Extract-Lederle*; Duck Feathers Allergenic Extract-Lederle *; Goose Feathers Allergenic Extract-Lederle *; Parrot Feathers Allergenic Extract- Lederle *; Pigeon Feathers Allergenic Extract-Lederle *; Turkey Feathers Allergenic Extract-Lederle.* Products marketed in dilutions representing 0.1 mg. and 0.01 mg. of nitrogen per cc. : Brazil Nut Allergenic Extract-Lederle ^; Cashew Nut Allergenic Extract-Lederle ^; Chestnut (Spanish) Allergenic Extract- Lederle^; Coconut Allergenic Extract-Lederle^; Hazel Nut Allergenic Extract-Lederle^; Hickory Nut Allergenic Extract-Lederle^; Pecan Aller- genic Extract-Lederle ^; Pepper (Black) Allergenic Extract-Lederle •; Pepper (Red) Allergenic Extract-Lederle^; Pignolia Nut Allergenic Extract-Lederle ^; Pistachio Nut Allergenic Extract-Lederle ^; Walnut (Black) Allergenic E.rtract-Lederle *; Walnut (English) Allergenic Extract-Lederle.^ Products marketed in dilutions representing 0.1 mg. and 0.001 mg. of nitrogen per cc:' Caraway Seed Allergenic Extract-Lederle^; Lycopodium Allergenic Extract-Lederle '' ; Poppy Seed Allergenic Evtract-Lederle.^ ALLERGENIC PROTEIN PREPARATIONS 31 Products marketed in dilutions representing 0.1. 0.01 and 0.001 mg. ot nitrogen per cc: Camel Dander Allergenic Extract-Lederle * ; Cuttlefish Allergenic Extract-Lederle*; Deer Dander Allergenic Extract-Lederle*; Hog Dander Allergenic Extract-Lederle.* Products marketed in dilutions representing 0.1 mg. and 0.00001 mg. of nitrogen per cc. : Castor Bean Allergenic Extract-Lederle.^' Products marketed in dilutions representing 0.05 mg. and 0.001 mg. tif nitrogen per cc. : Guinea Pig Dander Allergenic Extract-Lederle.* Products marketed in dilutions representing 0.01 mg. of nitrogen per cc: Ascaris Allergenic Extract-Lederle.^ Products marketed in dilutions representing 0.01 mg. and 0.001 mg. of nitrogen per cc: Mink Dander Allergenic Extract-Lederle *; Muskrat Dander Allergenic Extract-Lederle *; Raccoon Dander Allergenic Extract- Lederle.* Products marketed in dilutions representing 0.001 mg. of nitrogen per cc. : Fox Dander Allergenic Extract-Lederle *; Mouse Dander Aller- genic Extract-Lederle.* Allergenic extracts-Lederle are prepared from various substances by extraction with a buffered saline solution composed of sodium chloride 0.5 Gm., potassium dihydrogen phosphate (KH2PO4) 0.0363 Gm., sodium phosphate (Na2HP04.12H20) 0.1431 Gm., Phenol 0.4 Gm., distilled water to make 100 cc. Certain of these products are standard- ized on the basis of their nitrogen content per unit volume. Certain others, however, do not lend themselves to such standardization and are marketed with the designations "Undiluted," "1:10 Dilution," "1:100 Dilution," etc. These "Undiluted Extracts" are ten times the strength of extracts found safe and effective in known sensitive individuals by the dermal test. Products marked 1 are prepared by the following method: The material is shelled and ground, treated with toluene, alcohol and ether. The dry and oil-free flour is extracted with the buffere'd solution. The extract is dialyzed and sterilized by filtration. Products marked 2 are prepared by the following method: The powdered whole grains are washed with toluene, alcohol and ether. The buffered saline extract of the defatted flour is dialyzed, concen- trated and sterilized by filtration. Products marked 3 are prepared by the following method: The ground material is treated with toluene and then placed immediately in the buffered extracting fluid. The extract is dialyzed and sterilized by filtration. Products marked 4 are prepared by the following method. The material is ground in a mortar and washed with ether and alcohol. The dry residue is extracted with buffered extracting fluid. The dialyzed extract is concentrated and the amount of nitrogen per cubic centimeter of the filtered extract is determined by the Kjeldahl method. Products marked 5 are prepared by the following method: The material is prepared by dialyzing the pressed juice at once against the buffered solution diluted (1-2) until nonirritating to normal skins. The dialyzed extract is concentrated and sterilized by filtration. If the ground material contains very little juice, it is mixed with the extracting fluid and the pressed extract is handled the same as an original juice. Products marked 6 are prepared by the following method: These extracts are merely dilutions of _ the original substance in the buffered saline solution. Milk is decaseinated with rennin. The whey is dia- lyzed against a slightly alkaline buffered solution, concentrated and sterilized by filtration. Products marked 7 are prepared by the following method: The powdered material is washed with toluene, alcohol and ether. The buffered saline extract of the defatted flour is dialyzed, concentrated and sterilized by filtration. The alcohol-ether treatment is exhaustive and the dialysis continued for a long time in order to insure stability of the extract and complete removal of toxic fractions present. 32 NEW AND NONOFFICIAL REMEDIES The product marked 8 is prepared by the following method: Raw unroasted cacao beans are ground and treated with toluene and ether until practically oil free. The resulting powder is extracted with the buffered solution. The extract is sterilized by filtration and standard- ized on the nitrogen basis per cubic centimeter. The product marked 9 is prepared by the following method: The powdered material is washed with toluene, alcohol and ether. After evaporation of the fat solvent, it is extracted with the buffered solution. The extract is dialyzed until skin tests prove it to be no longer irri- tating. The final product is sterilized by filtration and standardized on the basis of its nitrogen content per cubic centimeter. The product marked 10 is prepared by boiling the heads of any com- mon fish for one hour in acidified distilled water; for example, 40 pounds of fish heads in 30 liters of water with 45 cc. of glacial acetic acid. The resulting extract is filtered while hot through cloth yielding 25 liters of fluid of pH 5.0. The extract is evaporated on a steam bath to 2 liters of thick residue, representing the stock material from which simple saline dilutions are made. The product marked 11 is prepared in the following manner: vacuum cleaner collections from New York apartment houses are dried, sifted and extracted with toluene, alcohol and ether. The dry powder is then extracted under toluene with the buffered solution. After dialysis, the extract is concentrated and sterilized. The product marked "12" is prepared by the following method: The ground material is washed with toluol, alcohol and ether until practically oil free. The resulting residue is dried and extracted with the buft'ered solution. The extract is boiled for three minutes for detoxification. The coagulum formed is separated at once from the extract by filtra- tion. The toxin free extract is sterilized by filtration and standardized on the basis of its nitrogen content. The product marked "13" is prepared by the following method: The dried worms are ground and treated with toluol and ether until prac- tically fat free. The residue is extracted with the buffered solution. The dialyzed extract is sterilized by Berkefeld filtration and standardized according to its nitrogen content. ALLERGENIC EXTRACTS-MULFORD. — Liquids obtained by extracting" the protein of substances believed to be the cause of specific sensitization. Actions and Uses. — See general article Allergenic Protein Preparations. Dosage. — See general article, Allergenic Protein Preparations. Allergenic Extracts-Mulford are marketed in 2 cc, ampule vials containing 1,500 nitrogen units per cubic centimeter, except allergenic preparations marked (*), which contain 100 nitrogen units per cubic centimeter. Manufactured by Sharp & Dohme, Philadelphia and Baltimore. No U. S. patent or trademark. Almond Allergenic Extract-Mulford,^ Apple Allergenic Extract-Mulford,- Apricot Allergenic Extract-Mulford,^ Artichoke Allergenic Extract- Mulford,^ Asparagus Allergenic Extract-Mulford,"^ Banana Allergenic Extract-Mnlford,^ Barley Allergenic Extract-Mulford,^ Bass (Sea) Aller- genic Extract-Mulford,^ Bean (Kidney) Allergenic Extract-Mulford,^ Bean (Lima) Allergenic Extract-Midjford,^ Bean (Navy) Allergenic Extract-Mtilford,^ Bean (Soy) Allergenic Extract-Mulford,^ Bean (String) Allergenic Extract-Miilford,^ Beef Allergenic Extract-Mulfard,^ Beet Allergenic Extract-Miilford,^ Blackberry Allergenic Extract-Mulford,^ Bluefish Allergenic Extract-Mulford,^ Brazilntit Allergenic Extract- Mulford} Brussels Sprouts Allergenic Extract-Mulford,^ * Buckwheat Allergenic Extract-Mulford} Butternut Allergenic Extract-Mulford,^ Cabbage Allergenic Extract-Mulford,^ Cantaloupe Allergenic Extract- Mulford,^ Carp Allergenic Extract-Mulford,^ Carrot Allergenic Extract- ALLERGENIC PROTEIN PREPARATIONS 33 Mulford,^ Cauliflower Allergenic Extract-Mulford,^ Celery Allergenic Extract-Mulford,^ Cheese (American) Allergenic Extract-Mulford,^ Cheese (Sztnss) Allergenic Extract-Mulford,^ Cherry Allergenic Extract-Mulford,- Chestniit Allergenic Extract-Mulford} Chicken Allergenic Extract- Miilford,^ Cinnamon Allergenic Extract-Mulford} Clam Allergenic Extract-Mulford,^ Clove Allergenic Extract-Mulford} *Cocoa Allergenic Extract-Mulford,^ Coconut Allergenic Extract-Mulfard,^ Codfish Aller- genic Extract-Mulford,^ Coffee Allergenic Extract-Mulford,^ Corn Aller- genic Extract-Mulford,^ Crab Allergenic Extract-Mulford,^ Cranberry Allergenic Extract-Mulford,'^ Cucumber Allergenic Extract-Mulford,^ Duck Allergenic Extract-Mulford,^ Egg Plant Allergenic Extract-Mulford,'^ *Egg White Allergenic Extract-Mulford,^ *Egg (Whole) Allergenic Extract- Mulford,^ *Egg Yolk Allergenic Extract-Mulford,^ Fig Allergenic Extract- Mulford,'^ Garlic Allergenic Extract-Mulford,'^ *Ginger Allergenic Extract-Mulford,^ Goose Allergenic Extract-Mulford,^ Grape Allergenic Extract-Mulford,^ Grapefruit Allergenic Extract-Mulford,'^ Haddock Aller- genic Extract-Mulford,^ Halibut Allergenic Extract-Mulford,^ Herring Allergenic Extract-Mulford,^ Hickory Nut Allergenic Extract-Mulford,^ Honey Dew Allergenic Extract-Mulford,'^ Huckleberry Allergenic Extract- Mulford,'^ *Lactalbumen Allergenic Extract-Mulford,^ Lamb Allergetiic Extract-Mulford,^ Lemon Allergenic Extract-Mulford,^ Lentil Allergenic Extract-Mulford,'^ Lettuce Allergenic Extract-Mulford,^ Lobster Alley genie Extract-Mulford,^ Mackerel Allergenic Extract-Mulford,'^ *Milk (Cow) Allergenic Extract-Mulford,'' Mushrooms Allergenic Extract-Mul- ford,'^ *Mustard Allergenic Extract-Mulford,^ Nutmeg Allergenic Extract- Mulford,^ Oats Allergenic Extract-Mulford,^ Okra Allergenic Extract- Mulford,"^ Olive Allergenic Extract-Mulford,'^ Onion Allergenic Extract-Mulford,"^ Orange Allergenic Extract-Mulford,'^ Oyster Allergenic Extract-Mulford,^ Parsley Allergenic Extract-Mulford,"^ Parsnip Aller- genic Extract-Mulford,^ Paprika Allergenic Extract-Mulford,'^ Pea (Green) Allergenic Extract-Mulford,"^ Pea (Black-Eyed) Allergenic Extract- Mulford,'^ Peach Allergenic Extract-Mulford,'^ Peanut Allergenic Extract- Mulford,^ Pear Allergenic Extract-Mulford,'^ Pecan Allergenic Extract-Mulford,^ *Pepper (Black) Allergenic Extract-Mulford,^ Pepper (Red) Allergenic Extract-Mulford,^ Pepper (Szveet) Allergenic Extract- Mulford,^ Perch Allergenic Extract-Mulford,^ Pineapple Allergenic Extract-Mulford,'^ Plum Allergenic Extract-Mulford,'^ Pork Allergenic Extract-Mulford,^ Potato (White) Allergenic Extract-Mulford," Potato (Sweet) Allergenic Extract-Mulford,'^ Prune Allergenic Extract-Mulford, '^ Pumpkin Allergenic Extract-Mulford,'^ Radish Allergenic Extract-Mulford,' Raisin Allergenic Extract-Mulford," Raspberry Allergenic Extract- Mulford," Rhubarb Allergenic Extract-Mulford," Rice Allergenic Extract-Mulford,^ Rye Allergenic Extract-Mulford,^ Salmon Allergenic Extract-Mulford,^ Scallop Allergenic Extract-Mulford,^ Shad Aller- genic Extract-Mulford,^ Shad Roe Allergenic Extract-Mulford,^ Shrimp Allergenic Extract-Mulford,^ Smelt Allergenic Extract-Mulford,^ Sole Allergenic Extract-Mulford,^ Spinach Allergenic Extract-Mulford," Squash Allergenic Extract-Mulford," Strawberry Allergenic Extract- Mulford," Swiss Chard Allergenic Extract-Mulford," Tea Allergenic Extract-Mulford,^ Tomato Allergenic Extract-Mulford," Trout (Sea) Aller- genic Extract-Mulford,'^ Tuna Fish Allergenic Extract-Mulford,^ Turkey Allergenic Extract-Mulford,^ Turnip Allergenic Extract-Mulford,'^ Vanilla Allergenic Extract-Mulford,'^ Veal Allergenic Extract-Mulford,^ Walnut (Black) Allergenic Extract-Mulford,'^ Walnut (English) Allergenic Extract-Mulford,^ Watermelon Allergenic Extract-Mulford," * Wheat Aller- genic Extract-Mulford,^ 'Yeast Allergenic Extract-Mulford," *Camel Hair Allergenic Extract-Mulford,'^ *Cat Hair Allergenic Extract-Mulford,* *Cattle Dander Allergenic Extract-Mulford,* *Chicken Feathers Allergenic Extract-Mulford,* *Dog Hair Allergenic Extract-Mulford,* *Duck Feathers Allergenic Extract-Mulford,* *Goat Hair Allergenic Extract-Mulford,* *Goose Feathers Allergenic Extract-Mulford,* *Guinea-Pig Hair Allergenic Extract-Mulford,* Hog Hair Allergenic Extract-Mulford,* *Horse Dander Allergenic Extract-Mulford,* *Rabbit Hair Allergenic Extract-Mulford,* *Sheep Wool Allergenic Extract-Mulford,* ^Cottonseed Allergenic Extract- Mulford,'^ Dust, House, Allergenic Extract-Mulford,^ *Flaxseed Allergenic Extract-Mulford,'^ *Glue (Fish) Allergenic Extract-Mulford,^^ *Horse Serum Allergenic Extract-Mulford,^ *Kapok Seed Allergenic Extract- 34 NEW AND NONOFFICIAL REMEDIES Miilford,^ *Orris Root Allergenic Extract-Mulford,^ *Pyrethrum Allergenic Extract-Mulford,^ *Rice Polish Allergenic Extract-Mulford,^ Silk Aller- genic Extract-Mulford,^ Tobacco Allergenic Extract-Mulford.^ Allergenic Extracts-Mulford are prepared by extracting various sub- stances with buffered salt solution, consisting of monobasic potassium phosphate (KH2PO4) 0.363 Gm., dibasic sodium phosphate (NasHPO*) 1.43 Gm,, and sodium chloride (NaCl) 5 Gm., in 1 liter of distilled water containing 0.4 per cent of phenol. Products marked 1 are prepared for extraction as follows: The crude material is ground as fine as possible. The powder, or flour, is placed in a Buchner funnel and washed with carbon tetrachloride until the wash- ings are clear and colorless. The caibon tetrachloride is removed with ether. The washings are discarded and the residue is dried. The dried residue is extracted under toluene with buffered salt solution from one to three days at room temperature. Products marked 2 are prepared for extraction as follows: The fruits or vegetables are ground as fine as possible. Buffered salt solution is added to the ground pulp and allowed to extract under toluene from one to three days at room temperature. Products marked 3 are prepared for extraction as follows: The muscle fibers, after the removal of fat and tendons, are ground as fine as possible. The ground muscle is washed with toluene until free from fats and oils. The toluene washings are discarded. The ground meat is extracted under toluene with buffered salt solution from one to three days at room temperature. Products marked 4 are prepared for extraction as follows: The feathers or hair are washed with ether and the suspended particles of dander are collected by filtration. The dried material is extracted under toluene with buffered salt solution from one to three days at room temperature. Preparations marked 5 are prepared for extraction as follows: The yolk of an egg is separated from the white in a sterile manner. One part of egg white, or egg yolk, is diluted with four parts of sterile buffered salt solution. Lactalbumen, marked 6, is prepared for extraction as follows: The fat from 1 liter of milk is removed by centrifugation. The fat-free milk is saturated at 30 C. with magnesium sulfate, which precipitates the caseinogen and lactoglobulin. The filtrate is acidified with acetic acid so that the content of the acid is 1 per cent. The precipitate is filtered off, pressed out, and dissolved in water; the solution is neutralized and dialyzed. (Practical Organic and Bio-Chemistry, R, H, A, Plimmer, p. 446). Milk, marked 7, is prepared for extraction as follows: One liter of fresh nonheated milk, from which the fat has been removed by cen- trifugation, is mixed with 3 cc, of 1 per cent rennin solution and placed in a water bath at 27 C, for one-half hour. The precipitated casein is removed by straining through a sterile towel. The filtrate is neutralized with saturated solution of sodium bicarbonate, and sterilized by filtra- tion (J. Immunol. 15:2, 1928). Dust, marked 8, is prepared for extraction as follows: The dust is washed with ether and extracted under toluene with a mixture of two parts of alkaline extracting fluid (2.5 Gm. of sodium bicarbonate and 5 Gm. of sodium chloride in 1 liter of distilled water) and one part of buffered salt solution saturated with carbon dioxide. The extract is dialyzed against the same fluid, passing carbon dioxide constantly during the period of dialysis. After dialysis, the extract is evaporated (electric fan) and, during the process carbon dioxide is kept constantly bubbling through the fluid (/. Immunol. 15:2, 1928). Horse serum, marked 9, is prepared for extraction as follows: Normal horse serum containing 0.4 per cent of phenol as a preservative is used. Glue, marked 10, is prepared for extraction as follows: Glue is extracted with buffered salt solution. Allergenic Extracts-Mulford are tested and standardized in terms of "nitrogen units." The nitrogen unit has been arbitrarily chosen as 0.00016 mg. of nitrogen. ALLERGENIC PROTEIN PREPARATIONS 35 CONCENTRATED POLLEN ANTIGENS- LEDERLE. — Liquids obtained by extracting the protein from the pollen of plants with a liquid consisting of 67 per cent of glycerin and 33 per cent of a buffered saline solution. Actions and Uses. — See preceding article, Allergenic Protein Preparations. Dosage. — See preceding article, Allergenic Protein Prepa- rations. Concentrated pollen antigens-Lederle are marketed in the following packages : Complete Scries : fifteen syringes contain- ing, respectively, 2.5, 5, 10, 20. 35, 60, 100, 165, 275, 450, 750, 1,200, 1,800, 2,400 and 3,000 pollen units. Series A : five syringes containing for each consecutive dose (1 to 5, inclusive) 2.5, 5, 10, 20 and 35 pollen units, respectively. Series B : five syringes containing for each consecutive dose (6 to 10, inclusive) 60, 100, 165, 275 and 450 pollen units, respectively. Series C : five syringes containing for each consecutive dose (11 to 15, inclusive) 750, 1,200, 1,800, 2,400 and 3,000 pollen units, respectively. Series D : five syringes, each containing 3,000 units. Scries E : five syringes, each containing 6,000 units. Series F : five syringes containing, respectivelv, 3,600, 4,200, 4,800, 5,400 and 6,000 pollen units. Manufactured by the Lederle Laboratories, Inc., Pearl River. New York. No U. S. patent or trademark. Concentrated Pollen Antigen (Lederle) Ragweed Combined (Conunon and Giant Ragweed in equal parts). The following product is supplied in five syringe packages representing series A, D, C and F : Mixed Grasses, Concentrated Pollen Antigen-Ledcrlc (June Grass, Orchard Grass, Sweet Vernal Grass, Red Top and Timothy, in equal parts). Concentrated pollen antigens-Lederle are prepared by grinding the dried pollen with glass dust for six hours, using a diluent composed of 67 per cent glycerin and 33 per cent of a solution containing 0.5 per cent sodium chloride, 0.27 per cent sodium bicarbonate and 0.4 per cent phenol, to moisten the pollen. The material is shaken in a mechanical shaker, incubated for eighteen hours, shaken again, paper- pulped, and Berkefeld filtered. The finished stock extract contains .10.000 pollen units per cubic centimeter, the pollen unit having been arbitrarily chosen as the equivalent of 0.00001 mg. of total nitrogen. Concentrated pollen antigens-Lederle are standardized by the com- plement fixation method to determine the active antigenic power of their protein content. Immune serum is obtained from rabbits which have been immunized with a gradually increasing number of units of pollen. Using the same technic for complement fixation as that adopted by the Research Laboratories for the Department of Health. New York, one pollen unit is found to be equivalent approximately to one-twentieth unit of antigen, a unit of antigen being taken as the smallest amount that gives complete fixation in the hemolytic series. CONCENTRATED POLLEN EXTRACTS-ABBOTT. —Liquids obtained by extracting the dried pollen of plants with a liquid consisting of 5 per cent of dextrose and 0.5 per cent of phenol in distilled water. 36 NEW AND NONOFFICIAL REMEDIES Actions and Uses. — See preceding article, Allergenic Protein Preparations. Dosage. — See preceding article, Allergenic Protein Prepara- tions. Concentrated pollen extracts are marketed in 2 cc. and 5 cc. vials. Manufactured by the Abbott Laboratories, North Chicago, 111. U. S. patent applied for. No U. S. trademark. Annual Sage Concentrated Pollen Extract; Arizona Ash Concentrated Pollen Extract; Ash Concentrated Pollen Extract; Bermuda Grass Con- centrated Pollen Extract; Black Walnut Concentrated Pollen Extract; Biennial Sage Concentrated Pollen Extract; Blue Grass Concentrated Pollen Extract; Box Elder Concentrated Pollen Extract; Burweed Marsh Elder Concentrated Pollen Extract; Canada Blue Grass Concentrated Pollen Extract; Cocklebur Concentrated Pollen Extract; Corn Concentrated Pollen Extract; Cosmos Concentrated Pollen Extract; Costal Sagebrush Concentrated Pollen Extract; Cottonwood Concentrated Pollen Extract; Crab Grass Concentrated Pollen Extract; Dandelion Concentrated Pollen Extract; English Plantain Concentrated Pollen Extract; Elm Con- centrated Pollen Extract; False Ragzveed Concentrated Pollen Extract- Giant Ragzveed Concentrated Pollen Extract; Goldenrod Concentrated Pollen Extract; Goose Grass Concentrated Pollen Extract; Hemp Concen- trated Pollen Extract; Hickory Concentrated Pollen Extract; Johnson Grass Concentrated Pollen Extract; Lamb's Quarters Concentrated Pollen Extract; Marsh Elder Concentrated Pollen Extract; Mixed Ragzveed (Ambrosia elatior and Ambrosia trifida) Concentrated Pollen Extract; Mountain Cedar Concentrated Pollen Extract; Mugwort Concentrated Pollen Extract; Oak Concentrated Pollen Extract; Orchard Grass Con- centrated Pollen Extract; Ox-Eye Daisy Concentrated Pollen Extract; Palmer's Amaranth Concentrated Pollen Extract; Plantain Concentrated Pollen Extract; Prairie Sage Concentrated Pollen Extract; Quailbrush Concentrated Pollen Extract; Redroot Pigzveed Concentrated Pollen Extract; Red Sorrel Concentrated Pollen Extract; Redtop Concentrated Pollen Extract; Russian Thistle Concentrated Pollen Extract; Sage-brush Concentrated Pollen Extract; Short Ragzveed Concentrated Pollen Extract; Slender False Ragzveed Concentrated Pollen Extract; Southern Ragweed Concentrated Pollen Extract; Spiny Amaranth Concentrated Pollen Extract: Sudan Grass Concentrated Pollen Extract; Sunflozver Concentrated Pollen Extract; Szveet Vernal Grass Concentrated Pollen Extract; Sycamore Concentrated Pollen Extract; Timothy Concentrated Pollen Extract; Western Ragzveed Concentrated Pollen Extract; Western Water Hemp Concentrated Pollen Extract; Yellozv Dock Concentrated Pollen Extract; Yellozv Fox-Tail Concentrated Pollen Extract. Concentrated pollen extracts-Abbott are prepared by grinding dried pollen with a menstruum composed of 5 per cent of dextrose and 0.5 per cent of phenol in distilled water. The extract is clarified by filtration and sterilized by passing the filtrate through Handler filters. The finished liquid is a 3 per cent extract of the dried pollen, each cubic centimeter representing 0.03 Gm. of dried pollen (30,000 units). POLLEN ALLERGEN SOLUTIONS-SQUIBB. — Solutions containing the sodium chloride-soluble protein from the isolated pollen of various species of plants. Pollen allergen solutions-Squibb are intended for the prevention and treatment of hay fever. Actions and Uses. — See preceding article, Allergenic Protein. Preparations. Dosage. — See preceding article. Allergenic Protein Prepa- rations. The following pollen allergen solutions-Squibb are marketed in treatment set packages of three 3.5 cc. vials, the first con- taining 100 protein nitrogen units per cubic centimeter, the ALLERGENIC PROTEIN PREPARATIONS 2>7 second containing 1,000 protein nitrogen units per cubic centi- meter, and the third containing 10,000 protein nitrogen units per cubic centimeter ; and in treatment sets consisting of : Set A : fifteen vials containing for each consecutive dose (1 to 15, inclusive) 10, 20, 40, 70, 100, 200, 350, 500, 750, 1,000, 1,000, 1,500, 2,500, 4,000 and 5,000 protein nitrogen units, respectively, and 15 vials of sterile diluent with which to make the proper dilution of each dose. Set D : five vials (dose 15) each containing 5,000 protein nitrogen units, and five vials of sterile diluent with which to make the proper dihition of each dose. Grasses Combined Pollen Allergen Solution-Stjidbb (Bermuda Grass, June Grass, Orchard Grass, Red Top and Timothy, in equal parts); Rag- zveed Combined Pollen Allergen Solution-Squibb. The following products are marketed in 5 cc. vials containing 10,000 protein nitrogen units per cubic centimeter: Ash Pollen Allergen Solution-Squibb ; Bermuda Grass Pollen Allergen Solution-Squibb; Black Walnut Pollen Allergen Solution-Squibb; Cali- fornia Black IValnut Pollen Allergen Solution-Squibb; Cocklebur Pollen Allergen Solution-Squibb; Corn Pollen Allergen Solution-Squibb ; Cot- tonwood (Necklace Poplar) Pollen Allergen Solution-Sqtiibb ; Dandelion Pollen Allergen Solution-Squibb; English Plantain Pollen Allergen Solution-Squibb; False Ragiveeds Combined Pollen Allergen Solution- Squibb (False Ragweed and Slender Ragzvecd in equal parts) ; Goldenrod Pollen Allergen Solution-Squibb ; Grasses Combined Pollen Allergen Solution-Squibb (Bermuda Grass, June Grass, Orchard Grass, Red Top and Timothy in equal parts); Johnson Grass Pollen Allergen Solution- Squibb; June Grass Pollen Allergen Solution-Squibb ; Marsh Elder Pollen Allergen Solution-Squibb ; Oak Pollen Allergen Solution-Squibb; Orachs (Shadscales) Combined Pollen Allergen Solution-Squibb (Red- scale, Shadscale and Wingscale in equal parts) ; Orchard Grass Pollen Allergen Solution-Squibb; Oregon Ash Pollen Allergen Solution-Squibb; Ragweed Combined Pollen Allergen Solution-Squibb (Giant Ragweed and Dzvarf Ragzveed in equal parts); Ragweed (Dwarf) Pollen Allergen Solution-Squibb ; Ragweed (Giant) Pollen Allergen Solution-Squibb ; Red Top Pollen Allergen Solution-Squibb ; Rye Grasses Combined Pollen Allergen Solution-Squibb (Perennial Rye Grass and Italian Rye Grass in equal parts); Russian Thistle Pollen Allergen Solution-Squibb ; Sagebrush Combined Pollen Allergen Solution-Squibb (Pasture Sage and Sage- brush in equal parts); Sweet Vernal Grass Pollen Allergen Solution- Squibb; Timothy Pollen Allergen Solution-Squibb; Western Ragweed Pollen Allergen Solution-Squibb; Woru\woods Combined Pollen Allergen Solution-Squibb (Biennial Wormwood, Dark Leaved Mugwort, Dragon Sagewort and Mugwort in equal parts). Manufactured by E. R. Squibb & Sons, New York. No U. S. patent or trademark. Pollen allergen solutions-Squibb are prepared by the following method : The pollen is weighed and extracted with 1 per cent sodium chloride solution for twelve hours. The protein nitrogen in the extract is determined by the Kjeldahl method after phosphotungstic acid pre- cipitation of the protein fraction and the extract is diluted with glycerin and 1 per cent sodium chloride solution until the final volume contains 50 per cent of glycejin. The solution is then filtered through a Berke- feld filter, and the filtrate is tested for sterility and diluted so that each dosage form contains the declared quantity of pollen nitrogen units. The protein nitrogen fraction of 0.00001 mg. is one protein nitrogen unit. POLLEN ANTIGENS-LEDERLE. — Liquids obtained by extracting the protein from the pollen of plants with a liquid consisting of 67 per cent glycerin and 33 per cent of a buffered saline solution. 38 NEW AND NONOFFICIAL REMEDIES Actions and Uses. — See preceding article, Allergenic Protein Preparations. Dosage. — See preceding article, Allergenic Protein Prepa- rations. Pollen antigens-Lederle are marketed in the following forms : Series A: five vials containing for each consecutive dose (1 to 5, inclusive) 2.5, 5, 10, 20 and 35 pollen units, respectively, and five vials of sterile diluent with which to make the proper dilution of each dose. Series B : five vials containing for each consecutive dose (6 to 10, inclusive) 60, 100, 165, 275 and 450 pollen units, respectively, and five vials of sterile diluent with which to make the proper dilution of each dose. Series C : five vials containing for each consecutive dose (11 to 15, inclusive) 750, 1,200, 1,800, 2,400 and 3,000 pollen units, respectively, and five vials of sterile diluent with which to make the proper dilution of each dose. Series D : five vials each containing 3,000 pollen units and five vials of sterile diluent with which to make the proper dilution of each dose. Complete Series: packages containing the 15 doses described in Series A, B and C. Manufactured by the Lederle Laboratories, Inc., Pearl River, N. Y. No U. S. patent or trademark. Annual Salt Bush Pollen Antigcn-Lederle; Arizona Ash Pollen Antigen- Lcdcrle; Arizona IValnut Pollen Antigen-Lcderle ; Ash Pollen Antigen- Lederle; Beech Pollen Antigen-Lederle ; Bermuda Grass Pollen Antigen-Lederle ; Birch Pollen Antigen-Lcderle; Black W^alnut Pollen Antigen-Lederle ; Careless Weed Pollen Antigen-Lederle ; Cocklebur Pollen Antigen-Lederle; Cottonwood Pollen Antigen-Lederle ; Giant Ragweed Pollen Antigen-Lcderle ; Green Sage Pollen Antigen-Lederle ; Hickory Pollen Antigcn-Lederle : Johnson Grass Pollen Antigen-Lederle; June Grass Pollen Antigen-Lederle (Poa pratensis) ; Lamb's Quarters Pollen Antigcn-Lederle; Marsh Elder Pollen Antigen-L.ederle; Mountain Cedar Pollen Antigen-Lcderle; Mugwort Pollen Antigen-Lederle; Oak Pollen Antigcn-Lederle; OHz'e Pollen Antigen-Lederle : Orchard Grass Pollen Antigen-Lederle; Pasture Sage Pollen Antigen-Lederle; Perennial Rye Grass Pollen Antigen-Lederle; Poplar Pollen Antigen-Lederle: Rabbit Bush Pollen Antigen-Lcderle; Ragweed Pollen Antigen-Lederle (Ambrosia elatior) ; Ragzvccd Combined Pollen Antigen-Lcderle (Common and Giant Ragweed, in equal parts); Redroot Pigweed Pollen Antigen-Lederle; Prostrate Pigweed Pollen Antigen-Lederle ; Plantain Pollen Antigen- Lederle; Redtop Pollen Antigen-Lederle; Russian Thistle Pollen Antigen- Lederle; Sage-brush Pollen Antigen-Lederle ; Shad Scale Pollen Antigen-Lederle: Sheep Sorrel Pollen Antigen-Lederle; Slender Ragweed Pollen Antigen-Lederle: Southwestern Ragweed Pollen Antigen-Lederle; Spiny Amaranth Pollen Antigen-Lederle; Summer Cypress Pollen Antigen-Lcderle ; Sweei Vernal Grass Pollen Antigen-Lederle; Sycamore Pollen Antigen-Lcderle; Timothy Pollen Antigen-Lederle; Western Water Hemp Pollen Antigen-Lederle ; Western Ragweed Pollen Antigen- Lederle; Yellow Dock Pollen Antigen-Lederle. The following product is marketed in package forms designated : Series E: five vials each containing 6,000 pollen units and five vials of sterile diluent with which to make the proper dilution of each dose. ALLERGENIC PROTEIN PREPARATIONS 39 Series F: five vials containing for each consecutive dose (16 to 20, inclusive) 3,600, 4,200, 4,800, 5,400 and 6,000 pollen units, respectively, and five vials of sterile diluent with which to make the proper dilution of each dose. Also in packages of three 3 cc. vials containing 100, 1,500 and 20,000 pollen units per cubic centimeter, respectively. Ragweed Combined Pollen Antigen-Lederle : also marketed in packages of three 3 cc. vials containing 100, 1,500, and 20,000 pollen units per cubic centimeter, respectively. The following product is supplied in five vial packages repre- senting series A, B, C and F, and in packages of three 3 cc. vials containing 100, 1,500 and 20,000 pollen units per cubic centimeter, respectively. Mixed Grasses Pollen Antigen-Lederle (June Grass, Orchard Grass, Sweet Vernal Grass, Red Top and Timothy, in equal parts). Pollen antigens-Lederle are prepared by grinding the dried pollen with glass dust in a mortar for six hours, using a diluent composed of 67 per cent of glycerin and 33 per cent of a solution containing 0.5 per cent sodium chloride, 0.27 per cent sodium bicarbonate arid 0.45 per cent phenol to moisten the pollen. The material is shaken in a mechanical shaker, incubated for eighteen hours, shaken again, paper pulped, and Berkefeld filtered. The finished stock extract contains 30,000 pollen units per cubic centimeter, the pollen unit having been arbitrarily chosen as the equivalent of 0.00001 mg. of total nitrogen. Pollen antigens-Lederle are standardized by the complement fixation method to determine the active antigenic power of their protein content. Immune serum is obtained from rabbits which have been immunized with a gradually increasing number of units of pollen. Using the same technic for complement fixation as that adopted by the Research Laboratories for the Department of Health, New York, one pollen unit is found to be equivalent approximately to one twentieth of a unit of antigen, taking a unit of antigen as the smallest amount that gives complete fixation in the hemolytic series. POLLEN ANTIGENS-"NATI ON AL."— Liquids obtained by extracting the dried pollen of plants with a 0.5 per cent sodium chloride solution containing approximately 0.28 per cent of sodium bicarbonate, and 0.4 per cent of phenol. Actions and Uses— See preceding article, Allergenic Protein Preparations. Dosage— See preceding article. Allergenic Protein Prepara- tions. Pollen antigens-"National" are marketed in packages of one 5 cc. vial containing 25 units per cubic centimeter ; in packages of one 5 cc. vial containing 50 units per cubic centimeter; in packages of one 5 cc. vial containing 100 units per cubic centi- meter; in packages of one 5 cc. vial containing 250 units per cubic centimeter; in packages of four 1 cc. syringes, containing 150units per cubic centimeter; and in packages of sixteen 1 cc. syringes containing, respectively, 2.5, 5, 10, 15, 22.5, 30, 40, 50, 50, 50, 50, 75, 75, 75, 100, and 100 units per cubic centimeter. The unit represents approximately 0.001 mg. of nitrogen. Manufactured by the National Drug Co., Philadelphia. No U. S. patent or trademark. 40 NEW AND NONOFFICIAL REMEDIES Ragzveed Pollen Antigen-" National" (Ambrosia elatior and Ambrosia trifida) ; Timothy Pollen Antigen-" National" (Phleum pratense). Pollen antigens "National" are prepared by the following method: The pollen is weighed and extracted with ether. After removal of the ether the pollen is mixed with the extracting liquid consisting of a 0.5 per cent sodium chloride solution containing approximately 0.28 per cent of sodium bicarbonate and 0.4 per cent of phenol and then covered with toluene. After four days, during which time the mixture is shaken once or twice daily, the supernatant fluid is decanted and the sediment mixed with a second portion of extracting fluid. As soon as the sedi- ment has settled, the supernatant fluid is decanted and mixed with the first portion. The combined decanted fluid is then subjected to Berke- feld filtration and tested for sterility. A Kjeldahl test is made on the concentrated extract to determine the nitrogen. Dilutions are prepared on a basis of 0.001 mg. of nitrogen per unit. POLLEN EXTRACTS-ARLCO.— Liquids obtained by extracting- the proteins from the pollen of various species of plants. Actions and Uses. — See preceding article, Allergenic Protein Preparations. Dosage. — See preceding article, Allergenic Protein Prepa- rations. Pollen extracts-Arlco are marketed in sets of five vials representing graduated concentrations, namely, 1 in 10,000, 1 in 5,000, 1 in 1,000, 1 in 500 and 1 in 100, respectively." Manufactured by the Arlington Chemical Co., Yonkers, N. Y. No U. S. patent or trademark. Acacia (Scap.) Pollen Extract-Arlco; Alfalfa Pollen Extract-Arlco; Arizona Ash Pollen Extract-Arlco; Arizona Cottonwood Pollen Extract- Arlco; Arizona Walnut Pollen Extract-Arlco; Ash Pollen Extract-Arlco; Aster Pollen Extract-Arlco; Bermuda Grass Pollen Extract-Arlco; Birch Mixture Pollen Extract-Arlco (White Birch, Black Birch and Yellozv Birch, in equal parts); Birch Pollen Extract-Arlco; Box Elder Pollen Extract-Arlco ; Burning Bush Pollen Extract-Arlco; Burr Ragweed Pollen Extract-Arlco; Burrowecd Pollen Extract-Arlco; Califortiia Mugwort Pollen Extract-Arlco; California Walnut (Black) Pollen Extract-Arlco; Carlessiveed Pollen Extract-Arlco; Carpet Sage Pollen Extract-Arlco; Cherry Pollen Extract-Arlco; Cocklebur Pollen Extract-Arlco; Cosmos Pollen Extract-Arlco; Clover Pollen Extract-Arlco; Corn Pollen Extract- Arlco; Dahlia Pollen Extract-Arlco; Daisy Pollen Extract-Arlco; Dande- lion Pollen Extract-Arlco; Dock Pollen Extract-Arlco; Elm Pollen Extract- Arlco; Fleabane (Common) Pollen Extract-Arlco; Golden Glow Pollen Extract-Arlco; Golden Rod Pollen Extract-Arlco; Goosefoot Pollen Extract-Arlco; Grass Mixture No. 1 Pollen Extract-Arlco (Timothy, June Grass, Orchard Grass ajid Red Top, in equal parts); Grass Mixture No. 2 Pollen Extract-Arlco (Timothy, 40 per cent; June Grass, Orchard Grass, Red Top and Sweet Vernal Grass, each 15 per cent); Grass Mix- ture No. 3 Pollen Extract-Arlco (Bermuda Grass and Johnson Grass, in equal parts); Greasezvood Pollen Extract-Arlco; Hemp Pollen Extract- Arlco; Hickory Pollen Extract-Arlco; Hill Sage Pollen Extract-Arlco; Indian Rice Pollen Extract-Arlco; Indian Wormzvood Pollen Extract- Arlco; Johnson Grass Pollen Extract-Arlco; June Grass Pollen Extract- Arlco (Poa pratensis): Live Oak Pollen Extract-Arlco; Locust Pollen Extract-Arlco; Maple Mixture Pollen Extract-Arlco (Red Maple, Ash- Leaved Maple; Norzvay Maple and Sugar Maple, in equal parts); Maple Pollen Extract-Arlco; Marsh Elder Pollen Extract-Arlco; Meadozv Fescue Pollen Extract-Arlco; Mexican Tea Pollen Extract-Arlco; Mountain Cedar Pollen Extract-Arlco; Mugzvort Pollen Extract-Arlco; Narcissus Pollen Extract-Arlco; Oak Mixture Pollen Extract-Arlco (White Oak, Red Oak, Black Oak and Szvamp Oak, in equal parts); Oak Pollen Extract-Arlco: Oat Grass Pollen Extract-Arlco; Olive Pollen Extract-Arlco; Orach Pollen Extract-Arlco; Orchard Grass Pollen Extract-Arlco; Pigzveed ALLERGENIC PROTEIN PREPARATIONS 41 Pollen Extract- Arlco; Pine Pollen Extract-Arlco; Plantain Pollen Extract- Arlco; Poplar Pollen Extract-Arlco ; Prairie Ragweed Pollen Extract-Arlco ; Prairie Sage Pollen Extract-Arlco; Privet Pollen Extract-Arlco; Rag- iveed Dzvarf and Giant Mixture Pollen Extract-Arlco (equal parts of each); Ragweed Mixture Plus Burzveed Marsh Elder Pollen Extract- Arlco; Ragweed Pollen Extract-Arlco (Ambrosia trifida) ; Ragweed Pollen Extract-Arlco (Ambrosia artemisaefolia) ; Red Fescue Pollen Extract- Arlco; Redtop Pollen Extract-Arlco; Rose Pollen Extract-Arlco; Russian Thistle Pollen Extract-Arlco ; Rye Pollen Extract-Arlco; Rye Grass Pollen Extract-Arlco; Sage-brush Pollen Extract-Arlco ; Sea Elite Pollen Extract- Arlco; Shad Scale Pollen Extract-Arlco; Slender Ragweed Pollen Extract- Arlco; Spiny Amaranth Pollen Extract-Arlco; Sunflower Pollen Extract- Arlco; Szveet Clover Pollen Extract-Arlco; Sweet Vernal Grass Pollen Extract-Arlco; Sycamore Pollen Extract-Arlco; Thistle Pollen Extract- Arlco; Timothy Pollen Extract-Arlco; Velvet Grass Pollen Extract-Arlco; Walnut Pollen Extract-Arlco; Western Cottonwood Pollen Extract-Arlco; Western Ragzveed (Giant) Pollen Extract-Arlco; Western Water Hemp Pollen Extract-Arlco; Wild Sunflower Pollen Extract-Arlco; Winter Fat Pollen Extract-Arlco; Willow Pollen Extract-Arlco; Yellow Daisy Pollen Extract-Arlco. Pollen extracts-Arlco are prepared by the method of Walker (.Am. J. M. Sc. 157:409 [March] 1919): To 0.5 Gm. of the dry pollen is added 44 cc. of sterile physiologic solution of sodium chloride and the mixture is shaken thoroughly at frequent intervals for twenty- four hours. Sufficient absolute alcohol (7 cc.) is then added to make the alcohol content 14 per cent. The mixture is thoroughly shaken at frequent intervals for twrenty-four hours, after which it is cen- trifugalized at high speed and the supernatant fluid is drawn off with a pipette. This liquid, therefore, consists of the pollen protein dis- solved in a 14 per cent alcoholic physiologic solution of sodium chloride, and it represents by weight, 1 part of pollen in 100 parts of solvent. This 1 in 100 solution is used as stock and from it other dilu- tions, such as 1 in 500, 1 in 1,000, \ in 5,000 and 1 in 10,000 are made. Cresol is added as a preservative. POLLEN EXTRACTS-CUTTER.— Liquids obtained by extracting the dried pollen of plants with a liquid consisting of 67 per cent of glycerin and 2)2) per cent of a buffered saline solution. Actions and Uses. — See preceding article, Allergenic Protein Preparations. Dosage. — See preceding article, Allergenic Protein Prepa- rations. Pollen extracts-Cutter are marketed in complete treatment set packages consisting of three vials representing graduated concentrations, namely, 1 in 10,000, 1 in 1,000 and 1 in 100, respectively ; and in single vial packages containing 5 cc. of a 1:100 solution. Manufactured by the Cutter Laboratory, Berkeley, Calif. No U. S. patent or trademark. Alkali Weed Pollen Extract-Cutter ; All Scale Pollen Extract-Cutter; Annual Salt Bush Pollen E.itract-Cutter; Arizona Ash Pollen Extract- Cutter; Bermuda Grass Pollen Extract-Cutter; Black Walnut Pollen Extract-Cutter; Box Elder Pollen Extract-Cutter; Burning Bush Pollen Extract-Cutter; Canary Grass Pollen Extract-Cutter; Careless Weed Pollen Extract-Cutter ; Coast Sagebrush Pollen Extract-Cutter ; Cocklebur Pollen Extract-Ctitter; Common Raazveed Pollen Extract-Cutter : Cam Pollen Extract-Cutter; Cottonzvood Pollen Extract-Cutter; False Ragweed Pollen Extract-Cutter; Foxtail Pollen Extract-Cutter; Giant Ragweed Pollen Extract-Cutter ; Johnson Grass Pollen Extract-Cutter ; June Grass Pollen Extract-Cutter : Lamb's Quarters Pollen Extract-Cutter; Mountain Cedar Pollen Extract-Cutter; Marsh Elder Pollen Extract-Cutter; Mugzvort Pol- len Extract-Cutter; Oak Pollen Extract-Cutter; Olive Pollen Extract- 42 NEW AND NONOFFICIAL REMEDIES Cutter; Orchard Grass Pollen Extract-Cutter; Plantain Pollen Extract- Cutter; Red Root Pigweed Pollen Extract-Cutter; Red Top Pollen Extract- Cutter; Russian Thistle Pollen Extract-Cutter ; Rye Grass Pollen Extract- Cutter; Sagebrush Pollen Extract-Cutter; Shad Scale Pollen Extract- Cutter; Timothy Pollen Extract-Cutter; Tumbleweed Pollen Extract- Cutter; Velvet Grass Pollen Extract-Cutter; Western Ragweed Pollen Extract-Cutter; Western Water Hemp Pollen Extract-Cutter ; Wild Oat Pollen Extract-Cutter. Pollen extracts-Cutter are prepared by extracting the dried pollen with a menstruum composed of 67 per cent of glycerin and 33 per cent of an aqueous solution containing potassium dihydrogen phosphate (KH2PO4), 0.0908 per cent; sodium phosphate (Na2HP04.12H20), 0.238 per cent; and sodium chloride, 0.85 per cent. The extract is clarified by Berkefeld filtration. The finished liquid is a 1 per cent extract of the dried pollen, each cc. representing 0.01 Gm. of dried pollen. POLLEN EXTRACTS CONCENTRATED-CUTTER. — Liquids obtained by extracting the dried pollen of plants with a liquid consisting of 67 per cent of glycerin and 33 per cent of a buffered saline solution. Actions and Uses. — See preceding article, Allergenic Protein Preparations. Dosage. — See preceding article, Allergenic Protein Prepa- rations. Pollen extracts concentrated-Cutter are marketed in single vial packages containing 5 cc. Manufactured by the Cutter Laboratory, Berkeley, Calif. No U. S. patent or trademark. Alkali Weed Pollen Extract Concentrated-Cutter ; Allscale Pollen Extract Concentrated-Cutter ; Annual Saltbush Pollen Extract Concentrated- Cutter; Arizona Ash Pollen Extract Concentrated-Cutter ; Bermuda Grass Pollen Extract Concentrated-Cutter ; Black Walnut Pollen Extract Concen- trated-Cutter; Box Elder Pollen Extract Concentrated-Cutter ; Burning Bush Pollen Extract Concentrated-Cutter ; Canary Grass Pollen Extract Concentrated-Cutter ; Careless Weed Pollen Extract Concentrated-Cutter ; Coast Sagebrush Pollen Extract Concentrated-Cutter ; Cocklebur Pollen Extract Concentrated-Cutter ; Common Ragweed Pollen Extract Concen- trated-Cutter; Corn Pollen Extract Concentrated-Cutter; Cottonwood Pollen Extract Concentrated-Cuttter ; False Ragweed Pollen Extract Con- centrated-Cutter; Foxtail Grass Pollen Extract Concentrated-Cutter ; Giant Ragweed Pollen Extract Concentrated-Cutter- Johnson Grass Pollen Extract Concentrated-Cutter ; June Grass Pollen Extract Concentrated- Cutter; Lamb's Quarters Pollen Extract Concentrated-Cutter; Marsh Elder Pollen Extract Concentrated-Cutter ; Mountain Cedar Pollen Extract Concentrated-Cutter; Mugwort Pollen Extract Concentrated-Cutter ; Oak Pollen Extract Concentrated-Cutter ; Olive Pollen Extract Concentrated- Cutter; Orchard Grass Pollen Extract Concentrated-Cutter ; Plantain Pollen Extract Concentrated-Cutter ; Red Root Pigweed Pollen Extract Concentrated-Cutter ; Redtop Pollen Extract Concentrated-Ciitter ; Russian Thistle Pollen Extract Concentrated-Cutter ; Rye Grass Pollen Extract Concentrated-Cutter; Sage-brush Pollen Extract Concentrated-Cutter ; Shad Scale Pollen Extract Concentrated-Cutter ; Timothy Pollen Extract Con- centrated-Cutter; Tumbleweed Pollen Extract Concentrated-Cutter ; Velvet Grass Pollen Extract Concentrated-Cutter; Western Ragweed Pollen Extract Concentrated-Cutter ; Western Water Hemp Pollen Extract Con- centrated-Cutter; Wild Oat Pollen Extract Concentrated-Cutter. Pollen extracts concentrated-Cutter are prepared by extracting the dried pollen with a menstruum composed of 67 per cent of glycerin and 33 per cent of an aqueous solution containing potassium dihydrogen phosphate (KHaPOi), 0.0908 per cent; sodium phosphate (Na2HP04. 12H20)j 0.238 per cent, and sodium chloride, 0.85 per_ cent. The extract is clarified by Berkefeld filtration. The finished liquid is a 3 per cent extract of the dried pollen, each cubic centimeter representing 0.03 Gm. of dried pollen. ALLERGENIC PROTEIN PREPARATIONS 43 POLLEN EXTRACTS-HOLLISTER-STIER.— Liquids obtained by extracting the dried pollen of plants with a liquid consisting of 48 per cent of glycerin, 3 per cent of sodium chloride and 49 per cent distilled water. Actions and Uses.— Sec preceding article, Allergenic Protein Preparations. Dosage.— Sec preceding article. Allergenic Protein Prepa- rations. Pollen extracts-Hollistcr-Stier are marketed in treatment sets of five vials containing, respectively, 20, 100, 1,000, 5,000 and 10,000 units per cubic centimeter accompanied by three vials of physiologic solution of sodium chloride for diluting the extract; in treatment sets of thirty vials, twenty containing 1, 3, 5. 7, 10, 15, 30, 50, 70, 100, 150, 200, 300, 400, 500, 600, 700, 800, 900, 1,000, and ten each containing 1,000 units, accom- panied by thirty vials of physiologic solution of sodium chloride for diluting the extract. Manufactured by the Hollister-Stier Laboratories, Spokane, Wash. No U. S. patent or trademark. Alder Pollen Extract-Hollister-Stier ; Aspen Pollen Extract-Hollister- Stier; Atriplex Pollen Extract-Hollister-Stier ; Awnless Brome Grass Pollen Extract-Hollister-Stier; Blue Bunch Grass Pollen Extract-Hollister-Stier ; Box Elder Pollen Extract-Hollister-Stier ; Canada Blue Grass Pollen Extract-Hollister-Stier ; Cheat Pollen Extract-Hollister-Stier; Common Sagebrush Pollen Extract-Hollister-Stier ; Crested Koeleria Pollen Extract- Hollister-Stier; Dandelion Pollen Extract-Hollister-Stier ; Eastern Ragweed Pollen Extract-Hollister-Stier ; English Plantain Pollen Extract-Hollister- Stier; Giant Poverty Weed Pollen Extract-Hollister-Stier ; Kentucky Blue Grass Pollen Extract-Hollister-Stier ; Lamb's Quarters Pollen Extract- Hollister-Stier; Mugwort Pollen Extract-Hollister-Stier ; Orchard Grass Pollen Extract-Hollister-Stier; Perennial Rye Grass Pollen Extract- Hollister-Stier; Quack Grass Pollen Extract-Hollister-Stier ; Redtop Pollen Extract-Hollister-Stier ; Redroot Pigweed Pollen Extract-Hollister-Stier ; Russian Thistle Pollen Extract-Hollister-Stier ; Sandberg's June Grass Pollen Extract-Hollister-Stier ; Sheep Sorrel Pollen Extract-Hollister Stier; Spring Birch Pollen Extract-Hollister-Stier ; Timothy Pollen Extract- Hollister-Stier; Velvet Grass Pollen Extract-Hollister-Stier ; Western Rag- weed Pollen Extract-Hollister-Stier ; Willow Pollen Extract-Hollister-Stier. Pollen extracts-Hollister-Stier are prepared by extracting the dried pollen with a menstruum composed of 48 per cent of glycerin, 3 per cent of sodium chloride and 49 per cent distilled water. The extract is clarified by Berkefeld filtration. The finished liquid is a 1 per cent extract of the dried pollen, each cubic centimeter representing 10,000 pollen units, 1 unit corresponding to 0.001 mg. of dried pollen. POLLEN EXTRACTS-MULFORD.— Liquids obtained by extracting the dried pollens of plants with a liquid contain- ing 0.5 per cent sodium chloride, 0.25 per cent sodium bicar- bonate, and 0.4 per cent phenol and standardized in terms of pollen units. The pollen unit is that commonly used, being the equivalent of 0.000016 mg. of nitrogen. Actions and Uses. — See preceding article, Allergenic Protein Preparations. Dosage. — See preceding article, Allergenic Protein Prepa- rations. 44 NEW AND NONOFFICIAL REMEDIES The following pollen extracts-Mulford are marketed in 5 cc. vials containing 2,000 pollen units per cubic centimeter, and, on special order, in 5 cc. vials containing 20,000 pollen units per cubic centimeter; those indicated by an asterisk are also marketed in syringe treatment packages containing graduated doses in the Alulford miniature syringe (^ cc.) and consist- ing of : First series : five syringes (doses 1 to 5, inclusive) containing, respectively, 5, 10, 20, 40 and 60 pollen units. Second series: five syringes (doses 6 to 10, inclusive) con- taining, respectively, 100, 200, 400, 700 and 1,000 pollen units. Third series: five syringes (doses 11 to 15, inclusive) con- taining, respectively, 1,500, 2,000, 3,000, 4,000 and 5,000 pollen units. Fourth series : five syringes (doses 16 to 20, inclusive) con- taining, respectively, 6,000, 7,000, 8,000, 9,000 and 10,000 pollen units. Fifteen dose series: fifteen syringes containing doses 1 to 15, inclusive, described in the First, Second and Third series. Alder Pollen Extract-Mulford; Alfalfa Pollen Extract-Mulford; Annual Sage Pollen Extract-Mulford; Apple Pollen Extract-Mulford; Arizona Ash Pollen Extract-Mulford* ; Arizona Walnut Pollen Extract-Mulford; Ash Tree Pollen Extract-Mulford; Aster Pollen Extract-Mulford; Barnyard Grass Pollen Extract-Mulford; Bermuda Grass Pollen Extract-Mulford*; Birch Pollen Extract Mulford; Blue Beech Pollen Extract-Mulford; Boneset Pollen Extract- Mulford; Box Elder Pollen Extract-Mulford* ; Brome Grass Pollen Extract-Mulford; Burning Bush Pollen Extract-Mulford; Burweed Marsh Elder Pollen Extract-Mulford; Buttercup Pollen Extract-Mulford; Cali- fornia Mugwort Pollen Extract-Mulford* ; Canary Grass Pollen Extract- Mulford; Careless Weed Pollen Extract-Mulford* ; Cedar Tree Pollen Extract-Mulford ; Chrysanthemum Pollen Extract-Mulford ; Clover Pollen Extract-Mulford; Coast Sage Pollen Extract-Mulford* ; Cocklebur Pollen Extract-Mulford* ; Corn Pollen Extract-Mulford: Cosmos Pollen Extract- Mulford; Cottonwood Tree Pollen Extract-Mulford* ; Crab Grass Pollen Extract-Mulford ; Dahlia Pollen Extract-Mulford; Daisy Pollen Extract- Mulford: Dandelion Pollen Extract-Mulford; Dock Pollen Extract- Mulford*; Dragon Sage Pollen Extract-Mulford; Elm Tree Pollen Extract-Mulford* ; English Plantain Pollen Extract-Mulford* ; False Ragweed Pollen Extract-Mulford* ; Fescue Grass Pollen Extract- Mulford*; Golden Glow Pollen Extract-Mulford; Goldenrod Pollen Extract-Mulford; Hemp Pollen Extract-Mulford; Hickory Tree Pollen Extract-Mulford; High Ragzveed Pollen Extract-Mulford* ; Johnson Grass Pollen Extract-Mulford* ; June Grass Pollen Extract-Mulford* ; Lamb's Quarters Pollen Extract-Mulford* ; Live Oak Pollen Extract-Mulford ; Low Ragweed Pollen Extract-Mulford* ; Maple Pollen Extract-Mulford* ; Marsh Elder Pollen Extract-Mulford* ; Mesquite Pollen Extract-Mulford; Mexican Tea Pollen Extract-Mulford ; Milo Maize Pollen Extract-Mulford; Mock Orange Pollen Extract-Mulford; Mountain Cedar Pollen Extract- Mulford* ; Mugwort Pollen Extract-Mulford; Oak Tree Pollen Extract- Mulford*; Oat Pollen Extract-Mulford; Olive Pollen Extract-Mulford; Orchard Grass Pollen Extract-Mulford* ; Papaw Pollen Extract-Mulford; Pasture Sage Pollen Extract-Mulford ; Peach Tree Pollen Extrad--Mulford ; Pecan Tree Pollen Extract-Mulford* ; Perennial Rye Grass Pollen Extract- Mulford*; Pine Tree Pollen Extract-Mulford; Plantain Pollen Extract- Mulford; Poverty Weed Pollen Extract-Mulford; Prairie Grass Pollen Extract-Mulford ; Prairie Sage Pollen Extract-Mulford* ; Primrose Pollen Extract-Mulford; Privet Pollen Extract-Mulford; Quack Grass Pollen Extract-Mulford; Rabbit Brush Pollen Extract-Mulford; Red Clover Pollen Extract-Mulford ; Redroot Pigweed Pollen Extract-Mulford* ; Red- ALLERGENIC PROTEIN PREPARATIONS 45 top Pollen Extract-Mulford* ; Rose Pollen Extract-Mulford; Russian Thistle Pollen Extract-Mulford* ; Rye Pollen Extract-Mulford*; Sage- brush Pollen Extract-Mulford* ; Sagezvort Pollen Extract-Mulford; Salt Bush Pollen Extract-Mulford*; Saw Grass Pollen Extract-Mulford; Shad Scale Pollen Extract-Mulford; Sheep Sorrel Pollen Extract-Mulford*; Slender Ragzvccd Pollen Extract-Mulford; Spiny Amaranth Pollen Extract-Mulford* ; Southern Ragzveed Pollen Extract-Mulford; Sudan Grass Pollen Extract-Mulford; Sugar Beet Pollen Extract-Mulford; Sun- ftozver Pollen Extract-Mulford; Szveet Clover Pollen Extract-Mulford : Szveet Vernal Grass Pollen Extract-Mulford* ; Sycamore Pollen Extract- Mulford*; Timothv Pollen Extract-Mulford*; Velvet Grass Pollen Extract-Mulford* ; Walnut Tree Pollen Extract-Mulford* ; Water Hemp Pollen Extract-Mulford* ; Western Giant Ragzveed Pollen Extract- Mulford; Western Ragweed Pollen Extract-Mulford* ; Wheat Pollen Extract-Mulford ; Wild Oats Pollen Extract-Mulford; Willozv Tree Pollen Extract-Mulford; Winter Grass Pollen Extract-Mulford; Wormzvood Pol- len Extract-Mulford* ; Yellozv Foxtail Grass Pollen Extract-Mulford. The following pollen extracts-Mulford are supplied in pack- ages of three 5 cc. vials containing, respectively, 100, 2,000 and 20,000 pollen units per cubic centimeter. Ragzveed Pollen Extract-Mulford ; Timothy Grass Pollen Extract- Mulford. The following products are marketed in vial and syringe treat- ment packages containing graduated doses, representing respec- tively 5, 10, 20, 40, 60, 100, 200, 400, 700, 1,000, 1,500, 2,000, 3,000, 4,000, 5,000, 6,000, 7,000, 8,000, 9,000 and 10.000 pollen units. Also in packages of three 5 cc. vials containing respec- tively 100, 2,000 and 20,000 pollen units per cubic centimeter : Grass Mixture Pollen Extract-Mulford (Timothy, June, Orchard, Szveet Vernal, and Red Top Grass Pollen in equal proportion) ; Grass Mixture Pollen Extract-Mulford (Pollens of Southzvestern Grasses: Bermuda Grass and Johnson Grass 30 per cent each, June Grass and Timothy Grass 20 per cent each). Manufactured by the Mulford Biological Laboratories, Sharp & Dohme, Philadelphia, Baltimore. No U. S. patent or trademarks. Mature pollen is thoroughly dried and extraneous material separated by various methods. The purified pollen is ground in a ball mill to break cell membranes. It is then extracted with a fluid containing 0.5 per cent sodium chloride, 0.25 per cent sodium bicarbonate, and 0.4 per cent phenol. Extraction is continued for twenty-four hours at room temperature, with the extracts saturated with carbon dioxide gas during the process. The extracts are then standardized in terms of pollen units, a pollen unit being the equivalent of 0.000016 mg. of nitrogen. They are sterilized by Berkefeld filtration and subjected to tests for sterility. POLLEN EXTRACTS-ABBOTT.— Liquids obtained by extracting the protein from the pollen of plants with a liquid consisting of 5 per cent of dextrose and 0.5 per cent of phenol in distilled water. Actions and Uses. — See preceding article, Allergenic Protein Preparations. Dosage. — See preceding article, Allergenic Protein Prepa- rations. Pollen extracts-Abbott are marketed in the following forms : Series I : five vials containing for each consecutive dose (1 to 5, inclusive) 5, 10, 20, 40 and 70 pollen units, respectively. 46 NEW AND NONOFFICIAL REMEDIES accompanied by a vial containing three 0.025 Gm. (^ grain) capsules ephedrine hydrochloride. Series II : five vials containing for each consecutive dose (6 to 10, inclusive) 100, 200, 400, 700 and 1,000 pollen units, respectively, accompanied by a vial containing three 0.025 Gm. (^ grain) capsules ephedrine hydrochloride. Series III : five vials containing for each consecutive dose (11 to 15, inclusive) 1,500, 2,000, 3,000, 3,500 and 4,000 pollen units, respectively, accompanied by a vial containing three 0.025 Gm. m grain) capsules ephedrine hydrochloride. Complete series : packages containing the 15 doses, described in Series I, II and III. Packages of one vial containing 4,000 pollen units. Mixed Grass Pollen Extract-Abbott (Timothy, June Grass, Orchard Grass, Red Top and Sweet Vernal Grass in equal proportions) ; Ragweed Pollen (Ambrosia elatior and Ambrosia trifida) Extract — Abbott. The following is marketed in special dilution sets : Mixed Ragzveed Pollen Extract Decimal Dilution Set: A mixture of equal parts of short and giant ragweed pollen extract, marketed in pack- ages of five vials containing respectively, 5 cc. of a 1 : 1 00,000 _ dilution (10 pollen units per cubic centimeter), 5 cc. of a 1 : 10,000 dilution (100 pollen units per cubic centimeter), 5 cc. of a 1:1,000 dilution (1,000 pollen units per cubic centimeter), 5 cc. of a 1 : 100 dilution (10,000 pollen units per cubic centimeter), and 0.5 cc. of a 3 per cent dilution (30,000 pollen units per cubic centimeter). Manufactured by the Abbott Laboratories, North Chicago, III. U. S. patent applied for. No U. S. trademark. Pollen extracts-Abbott are prepared by grinding dried pollen in a ball mill with a liquid composed of 5 per cent of dextrose and 0.5 per cent of phenol in distilled water. Sufficient of the menstruum is added so that the total volume is such that each cc. represents 20,000 units, 1 unit corresponding to 0.001 mg. of dried pollen. This mixture is filtered through paper pulp and then through a Berkefeld filter. It is tested for sterility before diluting, after dilution and after filling. POLLEN EXTRACTS-U. S. STANDARD PROD- UCTS CO. — Solutions prepared by extracting the dried pol- len of various species of plants with a buffered glycerosaline solution. Actions and Uses. — See preceding article, Allergenic Protein Preparations. Dosage. — See preceding article, Allergenic Protein Prepa- rations. All of the pollen extracts-U. S. Standard Products Co. are supplied in 5 cc. vials containing 20,000 units per cubic centi- meter. In addition, two of the products (Grasses Combined and Ragweed Combined) are marketed in single treatment set packages of three vials, containing respectively 100, 1,000 and 10,000 units per cubic centimeter and accompanied by a vial containing 2 cc. of epinephrine hydrochloride solution 1 : 1,000. Prepared by the United States Standard Products Company, Woodworth, Wis. No U. S. patent or trademark. ALUMINUM COMPOUNDS 47 Bermuda Grass Pollen Extract-U. S. S. P. Co.; Box Elder Pollen Extract-U. S. S. P. Co.; Burweed Pollen Extract-U. S. S. P. Co.; Careless Weed Pollen Extract-U. S. S. P. Co.; Cocklebur Pollen Extract- U. S. S. P. Co.; Corn Pollen Extract-U. S. S. P. Co.; Cosmos Pollen Extract-U. S. S. P. Co.; Cottonwood (Poplar) Pollen Extract-U. S. S. P. Co.; Dandelion Pollen Extract-U. S. S. P. Co.; Elm Pollen Extract- U. S. S. P. Co.; English Plantain Pollen Extract-U. S. S. P. Co.; Goldenrod Pollen Extract-U. S. S. P. Co.; Grasses Combined Pollen Extract-U. S. S. P. Co. (Bermuda Grass, June Grass, Orchard Grass, Red Top, Sweet Vernal Grass and Timothy in equal parts); Johnson Grass Pollen Extract-U. S. S. P. Co.; June Grass Pollen Extract-U. S. S. P. Co.; Lamb's Quarters Pollen Extract-U. S. S. P. Co.; Maple Pollen Extract-U. S. S. P. Co.; Marsh Elder Pollen Extract-U. S. S. P. Co.; Mugwort (Wormwood) Pollen Extract-U. S. S. P. Co.; Orchard Grass Pollen Extract-U. S. S. P. Co.; Pigweed (Redroot) Pollen Extract- U. S. S. P. Co.; Ragweed (Common) Pollen Extract-U. S. S. P. Co.; Ragweed (False) Pollen Extract-U. S. S. P. Co.; Ragweed (Giant) Pollen Extract-U. S. S. P. Co.; Ragweed (Western) Pollen Extract- U. S. S. P. Co.; Ragweed Combined Pollen Extract-U. S. S. P. Co. (Giant and Common Ragweed in equal parts); Red Oak Pollen Extract- U. S. S. P. Co.; Red Top Pollen Extract-U. S. S. P. Co.; Russian Thistle Pollen E.vtract-U. S. S. P. Co.; Rye Grass Pollen Extract- U. S. S. P. Co.; Sweet Vernal Grass Pollen Extract-U. S. S. P. Co.; Timothy Pollen Extract-U. S. S. P. Co.; White Ash Pollen Extract- U. S. S. P. Co.; White Oak Pollen Extract-U. S. S. P. Co. Prepared by extracting the dried pollen with a menstruum con- taining 67 per cent glycerin and 33 per cent of a physiologic solution of sodium chloride containing 0.0908 per cent potassium dihydrogen phosphate and 0.238 per cent dibasic sodium phosphate. The pollen is extracted for twenty-two hours in a ball mill, pulped and clarified by Berkefeld filtration. The finished liquid is a 3 per cent extract of dried pollen. Each cubic centimeter represents 30,000 pollen units, one pollen unit being the equivalent of 0.001 mg. of dried pollen. The marketed products represent appropriate dilutions of this stock solu- tion and are preserved with 0.35 per cent of phenol. ALUMINUM COMPOUNDS Several of the compounds of aluminum are official, including the ordinary alum or alumen, U. S. P. Aluminum acetate and aluminum subacetate are used in the form of solutions and are described in the National Formulary as Solution of Aluminum Acetate and Solution of Aluminum Subacetate. The aluminum compounds are used for their astringent action. Since they are but little absorbed, they are relatively nontoxic. Compounds of aluminum are astringent because of their property of precipitating albumin. The exsiccated alum is more energetic, not only because it contains a larger proportion of alum than the crystalline form, but because it absorbs water from the tissue at the same time. The acetate is milder than the sulfate, as is usual with metallic salts. The aluminum compounds are not so astringent as the corre- sponding lead salts, but they may exert an irritant and even caustic action when used in concentrated solutions or in the form of the exsiccated (burnt) alum. When swallowed in over- doses in such concentrated form, they may cause gastritis and diarrhea. Alum is sometimes used as an emetic. ^ The aluminum compounds are slightly antiseptic, a property which goes with their astringency. Some of the organic 48 NEW AND NONOFFICIAL REMEDIES compounds are said to be more actively antiseptic than the inorganic ones. Several proprietary preparations, consisting of aluminum com- bined with organic acids, have been introduced with a view to utilizing the astringent and antiseptic properties of their com- ponents. Many of these possess no special advantages and have fallen into disuse, or have been largely replaced by others of a more or less similar nature. ALUM. — ''Contains not less than 99.5 per cent of Ammonium Alum [AlNH4(S04)2.12HoO] or of Potassium Alum [AlK (S04)2.12H20]. The label of the container must indicate whether the salt is Ammonium Alum or Potassium Alum."- U . S. P. For standards see U. S. Pharmacopeia under Alumen. For actions, uses and dosage see Useful Drugs under Alumen. ALUMNOL. — Alumini Naphtholsulfonas. — Aluminum Betanaphthol-Disulfonate. — Alo(CioH5.0H.(S03)2)3. — The aluminum salt of betanaphthol-disulfonic acid. Actions and Uses. — Alumnol is used as a mild antiseptic and in concentrated solutions as an irritant or caustic. It is used for the destruction of the gonococcus, especially in cases of gonorrhea in women in which the endometrium is affected. Dosage. — As a surgical antiseptic, in from 0.5 to 3 per cent solutions ; in gynecology, in from 2 to 5 per cent solutions ; in otology and laryngology, either as a powder or in from 0.25 to 1 per cent solution as douches, washes or gargles ; as a cautery, in from 10 to 20 per cent solution. Manufactured by Farbwerke, vorm. Meister, Lucius & Bruening, Hoechst a.M., Germany (the Winthrop Chemical Co., Inc., New York, distributor). U. S. trademark 173,434. Alumnol is a fine, nearly white, nonhygroscopic powder. It js soluble in 1.5 parts of water, soluble in glycerin, sparingly soluble in alcohol and insoluble in ether. An aqueous solution is slightly fluo- rescent and produces a faintly acid reaction. When dried, it loses about 9 per cent of water, and, when exposed to the air, it is dark- ened in consequence of its reducing properties. It is precipitated from solution by albuminous and gelatinous bodies; but these pre- cipitates are redissolved in excess of the latter bodies. It is decom- posed by salts of silver or other reducible salts, by alkalis and by ammoniacal compounds. Dissolve about 1 Gm. of alumnol in 10 cc. of water: The solution is clear. Acidulate with hydrochloric acid: The liquid becomes at most only slightly turbid. Add a few drops of potassium ferrocyanide solu- tion : The liquid is tinted slightly bluish. On the addition of diluted sul- phuric acid or of ammonium oxalate solution to an aqueous solution of alumnol, no precipitate is formed. Incinerate about 2 Gm. of alumnol, accurately weighed: the amount of ash (alumina) is 12.7 per cent. AMINOACETIC ACID.— Glycocoll.— Glycine.— CH2NH2 COOH. Actions and Uses. — Observations of a number of workers have shown aminoacetic acid (glycocoll, glycine) to exert an AMINOACETIC ACID 49 appreciable effect on muscle creatine retention in certain cases of myasthenia gravis, and progressive or pseudohypertrophic mus- cular dystrophy. Coincident with the altered creatine metabo- lism clinical improvement has been reported. Dosage. — Aminoacetic acid is administered in an average dosage of from 20 to 30 Gm. daily, usually in some palatable liquid vehicle such as milk. Some workers have employed ephedrine in %6 to ^ grain dosage three or four times daily, conjointly with aminoacetic acid. Evidence for or against such use is controversial and the decision must depend on the indi- vidual case until more convincing studies are reported. Aminoacetic acid occurs as a light, white, odorless, crystalline powder, possessing a sweetish taste. It is freely soluble in water, very slightly soluble in alcohol, and practically insoluble _ in ether. Aminoacetic acid turns brown at about 228 C, and melts with decom- position (foaming) at 232-236 C. (U. S. P. XI method). Treat separately 2 cc. portions of an aqueous solution of aminoacetic acid (1: 10) as follows: Add. 0.3 cc. of diluted hydrochloric acid and 0.3 cc. of sodium nitrite solution (1 in 2) : a vigorous evolution of gas occurs. Add. 1 cc. of ferric chloride solution: a deep wine color forms, which disappears after addition of excess diluted hydrochloric acid solu- tion, and reappears on addition of excess stronger ammonia water. Add 0.1 cc. liquefied phenol solution and 5 cc. sodium hypochlorite solution (2 per cent active chlorine) : a blue color forms. Ten cc. of an aqueous solution (1 in 10) conforms to the U. S. P. XT test for heavy metals. Dissolve 3 Gm. of aminoacetic acid in from 30 to 40 cc. of water and treat according to the U. S. P. XI turbimetric test for chlorides: the turbidity is not more than that produced in a control test made with 0.25 cc. of fiftieth-normal hydrochloric acid. Dissolve 3 Gm. of aminoacetic acid in water and treat according to the U. S. P. XI turbimetric test for sulfates: the turbidity is less than that pro- duced in a control test made with 0.2 cc. of fiftieth-normal sulfuric acid. Boil 10 cc. of an aqueous aminoacetic acid solution (1 in 10) for one minute, and set aside two hours: the solution appears as limpid and mobile as before boiling. Heat about 1.0 Gm. of aminoacetic acid, accurately weighed, for four hours at 100 C.: the change in weight is not more than 0.0005 Gm. The ash from 1.0 Gm. weighs not more than 0.001 Gm. Treat from 0.26 to 0.32 Gm. of aminoacetic acid, accurately weighed, accord- ing to the procedure for nitrogen determination in Medical War Manual No. 6, Laboratory Methods of United States Army. 1919, p. 222; the nitrogen content is not less than 18.4 per cent nor more than 18.8 per cent. Aminoacetic Acid-Calco. — A brand of aminoacetic acid- N. N. R. Manufactured by the Calco Chemical Co., Bound Brook, N. J. No U. S. patent or trademark. Aminoacetic Acid-Merck. — A brand of aminoacetic acid- N. N. R. Manufactured by Merck & Co. Inc., Rahway, N. J. No U. S. patent or trademark. Aminoacetic Acid-Pfanstiehl. — A brand of aminoacetic acid-N. N. R. Manufactured by the Pfanstiehl Chemical Co., Waukegan, 111. No U. S. patent or trademark. 50 NEW AND NONOFFICIAL REMEDIES ANESTHETICS Anesthetics, General ETHYL CHLORIDE.— "Monochlorethaiie."—C/. 5'. P. For standards see the U. S. Pharmacopeia under Aethylis Chloridum; for actions and uses see Useful Drugs under Aethylis Chloridum. Kelene. — A brand of ethyl chloride-U. S. P., supplied in a special form of container. Manufactured by Fries Bros., New York (Merck & Co. Inc., Rahway, N. J., distributor). ETHYLENE.— 'Contains not less than 99.0 per cent by volume of C2H4."-U. S. P. For standards see the U. S. Pharmacopeia under Aethylenum. Caution. — Ethylene is inflammable, and its mixture with oxygen or air will explode when brought in contact ztnth a flame or an electric spark. Actions and Uses. — Animal experiments by W. E. Brown (Canad. M, A. J., March 1923, p. 210) and Luckhardt and Carter (J. A. M. A. 80:765 [March 17] 1923) indicated that ethylene has a direct action on the nervous system when a con- centration of 90 per cent ethylene and 10 per cent oxygen or less is used, that the motor reflexes are abolished with this concen- tration and that the phenomena produced by the undiluted gas are partly asphyxial, which effect can be removed by addition of oxygen to the ethylene itself. Trials on human subjects have confirmed the anesthetic and analgesic value of ethylene as demonstrated on animals. Deep surgical anesthesia is stated to be produced easily, and anal- gesia comes on readily and apparently long before surgical anesthesia is established. Given with oxygen, it has been found more powerful than nitrogen monoxide and in most instances as effective as ether ; unlike ether it causes no respiratory irri- tation and does not promote salivary secretion. Extensive use of ethylene in a wide variety of conditions failed to show it to be more explosive than ether-oxygen or ether-nitrous oxide-oxygen under comparable precautions. Under average conditions of ventilation ethylene, because of its rapid diffusibility, exists in explosive concentration (3.2 per cent) no further than two feet from the mask. Adequate ventilation of this area should eliminate largely the danger of explosion. No electrical devices should be employed within three or four feet of the mask. The ordinary operating room technique guarding against the presence of open flames, cautery and sparks should be observed. The advantages of ethylene consist in the production of an equally rapid but more pleasant induction; satisfactory relaxa- tion without cyanosis or sweating ; rapid recovery and decreased or absent post-operative nausea. ANESTHETICS 51 Dosage. — Ethylene is supplied in compressed state in metal containers. For use the gas is passed into an inhalation appa- ratus and is then inhaled with or without admixture of oxygen. The concentration employed for surgical anesthesia is generally 90 per cent ethylene and 10 per cent oxygen, though after a prolonged period of anesthesia, a deep anesthetic state may be maintained on 80 per cent ethylene. If the patient has been premedicated (morphine, barbital) less ethylene and more oxygen can be given. Ethylene-Cheney.— A brand of ethylene-U. S. P. The Cheney Chemical Co., Cleveland, distributor. No U. S. patent or trademark. Ethylene (Puritan Compressed Gas Corp.). — A brand of ethylene-U. S. P. Puritan Compressed Gas Corp., Kansas City, Mo., distributor. No U. S. patent or trademark. Ohio Ethylene.— A brand of ethylene-U. S. P. Manufactured by Ohio Chemical and Manufacturing Co., Cleveland. No U. S. patent or trademark. Walco Ethylene for Anesthesia. — A brand of ethylene- U. S. P. Manufactured by Wall Chemicals, Inc.. Detroit. METHYL CHLORIDE.—Methylis Chloridum.— CH3CI. — The hydrochloric acid ester of methyl alcohol. In the com- pressed state, methyl chloride is a colorless liquid, having an ethereal odor, and a sweet taste. Actions and Uses. — By its evaporation a temperature of — 23 C. is produced, while if evaporation is accelerated by means of a current of air a temperature of — 55 C. may easily be reached. On account of this property its use requires caution, since it is liable to produce blisters. The diluted vapor is said to be nonpoisonous. Alethyl chloride is said to be an efficient general anesthetic, which has practically no influence on the circulation, but fails to produce complete muscular relaxation. It is used as a general anesthetic mixed with ethyl chloride and ethyl bromide. Dosage. — When methyl chloride is sprayed on the skin, the part should be somewhat protected by a thin layer of cotton wool. When the anesthetic is used locally, cotton wool soaked in liquid methyl chloride may be applied to the skin over the painful area, but care should be taken that blisters are not formed. In order to avoid this, a mixture with ethyl chloride has been recommended. Methyl chloride is insoluble in water, more readily soluble in alcohol, freely soluble in ether and chloroform, and also in acetic acid. It should be neutral to litmus paper. Pure methyl chloride has a specific gravity of 0.99145 at — 23.7 C. It burns in air with a greenish flame, though it is not highly inflammable. The neutral solution is not precipitated by solution of silver nitrate, nor is there any reac- 52 NEW AND NONOFFICIAL REMEDIES tion with potassium iodide and starch paste. In the liquid condi- tion, it is a powerful refrigerating agent. At very low temperatures, it forms with water a hydrate, CH3C1,9H20. It should give an alkaline reaction to litmus (ammonia and methylated ammonia — methyl- aminej. It should not immediately form a precipitate with silver nitrate solution. On evaporating it should leave no residue and emit no odor of methylamine. TRICHLOROETHYLENE. — Trichloroethylenum. — Trichlorethylene. — CHCl : CCI2. — 1 -chloro-2-dichloro-ethylene. Actions and Uses. — The actions of trichloroethylene have not been investigated comprehensively, and it was introduced into therapeutics following some observations on man. Trichloro- ethylene appears to have a selective action on the sensory endings of the trigeminal nerve, whereby it affords relief in trigeminal neuralgia, but it is not clear that the action even of therapeutic doses is limited to these endings, and different individuals seem to show rather wide differences in susceptibility to this action ; hence the dose necessary to afford relief varies correspondingly. Therapeutic doses sometimes cause transitory giddiness, with lassitude, distress, palpitation and nausea. Large doses cause narcosis, and excessive doses cause death. There was no per- ceptible injury to the lungs, heart or liver after narcosis repeated several times in the dog, but there was slight hyperemia of the gastric mucous membrane and marked reddening of the duo- denum. The liquid is irritant ; hence it should not be allowed to come in contact with the nose when the vapor is inhaled. Dosage. — Fifteen minims by inhalation, to be repeated after a few minutes if necessary ; but it appears probable that not more than 60 minims should be inhaled within twenty-four hours when it is used for any considerable period of time. Trichloroethylene accurs as a clear, colorless, mobile and volatile liquid, possessing an odor similar to that of chloroform. It is miscible with ether and very soluble in alcohol; it is practically insoluble in water. The specific gravity is from 1.458 to 1.460 at 25 C. The refractive index is from 1.4770 to 1.4780 at 20 C. Transfer 25 cc. of trichloroethylene to a distilling flask. Determine the distillation range according to Method I of U. S. Pharmacopeia XI. Ninety-five per cent distils over at from 86 to 88 C. (corrected) at 760 mm. The refractive index of the distillate is the same as that of the material before distillation. Transfer 5 cc. of trichloroethylene to a glass stoppered cylinder, add 5 cc. bromine water and shake the mixture vigorously at intervals of fifteen minutes: at the end of an hour a white turbid solution forms in the lower layer. Agitate gently 5 cc. of trichloroethylene with 2 cc. of silver ammonium nitrate solution in a narrow glass stoppered cylinder of from 10 to 15 cc. capacity: no turbidity is observed in either layer at the end of ten minutes (acetylene). Agitate 20 cc. of trichloroethylene with a 50 cc. portion of water and repeat, using a 25 cc. portion of water; transfer the combined aqueous layer to a flask and add to the aqueous solution two drops of methyl red indicator solution: if the color of the solution is yellow, not more than 0.1 cc. of tenth normal hydrochloric acid is required to assume a pink color; if the color of the solution is pink, not more than 0.1 cc. of tenth normal sodium hydroxide is required to assume a yellow color. Agitate 10 cc. of trichloroethylene with 25 cc. of water and allow the liquid to separate completely. Separate 10 cc. portions of the aqueous layer are affected as follows: No turbidity is noted five minutes after the addition of 0.1 cc. of nitric acid and 0.1 cc. of silver nitrate solution ANESTHETICS 53 (chlorides) ; no blue color is observed after the addition of 0.1 cc. of potassium iodide test solution and 0.1 cc. of starch test solution (readily oxidizing substances such as free chlorine). Add 0.1 cc. of alcohol to 5 cc. of trichloroethylene: a turbid solution is formed {distinction from chloroform). Evaporate 25 cc. of trichloroethylene in a platinum or porcelain dish on a steam bath and dry to constant weight at 100 C: No weighable residue is obtained. Trichlorethylene-Calco. — A brand of trichloroethylene- N. N. R., marketed only in sealed frangible tubes. The prepa- ration contains in each cc. not more than 0.2 mg. of ammonium carbonate to prevent the thermal decomposition of trichloroethy- lene vapor which occurs during the sealing of the glass tubes. Manufactured by Calco Chemical Co., Inc. (a division of the American Cyanamid Co.), Bound Brook, N. J. No U. S. patent or trademark. Tubes Trichlorethylene-Calco, 1 cc. Anesthetics, Local There are three general groups of drugs used for the pro- duction of local anesthesia: (1) those which cause anesthesia through the production of cold, such as ether, ethyl chloride and methyl chloride ; (2) certain protoplasmic poisons, as quin- ine, and (3) those having a specific effect on sensory nerves or their endings, cocaine being the type of this class. The drugs listed below belong, in general, to the third class. They have been introduced with the object of finding substances less toxic and more stable and less injurious to the tissues than cocaine. Their anesthetic power is also as a rule some- what less than that of cocaine and most of them present the usually undesirable effect of dilating the blood vessels or at least of not constricting them as does cocaine, and are there- fore almost always employed in conjunction with epinephrine. The most important are based on the discovery that the local anesthetic action of cocaine is due to the radical of benzoic acid in combination with a nitrogen-containing basic group. The simplest of these compounds, ethylaminobenzoate (benzo- caine, anesthesine), is the ethyl ester of para-aminobenzoic acid, C6H4(NH2)COOH ; orthoform is the methyl ester of oxyamino- benzoic acid, NH2C6H3(OH)COOH. These are too weak or too slightly soluble in water to be useful for hypodermic injec- tion; they are used for local application (See "Anesthetics, Local, Slightly Soluble"). Procaine hydrochloride is the hydro- chloride of a compound of para-aminobenzoic acid with diethyl- aminoethyl alcohol ; its salts are readily soluble in water. Only those local anesthetics of relatively low toxicity should be injected where very small amounts are required. ALYPIN.— Alypin Hydrochloride.— The hydrochloride of 2-benzoxy-2-dimethylaminomethvl-l-dimethylaminobutane. — CHa CH^CCCeHsCOO) [CH^N (CH3)o] .CH.N : (CHa)...HCl. Actions and Uses. — Alypin is a local anesthetic, claimed to be equal to cocaine, but is not a mydriatic. It is said not to 54 NEW AND NONOFFICIAL REMEDIES produce disturbance of accommodation and to be less toxic than cocaine, but the evidence as to the relative toxicity of alypin and cocaine is rather conflicting. Death was reported in one case from the injection of about 3 drachms of a 4 per cent solution into the urethra; severe poisoning has resulted from smaller amounts. Dosage. — Alypin is used in solutions the strength of which is about the same as that of cocaine hydrochloride : in ophthal- mology, 2 to 4 per cent ; in rhinolaryngology, 5 to 10 per cent ; in urology, 1 to 4 per cent ; in minor surgery, 0.5 to 2 per cent, and in dentistry, 2 per cent. Alypin solutions may be sterilized by boiling the required amount of water for 10 minutes in a test tube stoppered with cotton; the drug is then added and the boiling continued over a small flame for another minute. Solutions should be freshly prepared. Epinephrine preparations may be added when a vaso- constrictor effect is desired. Manufactured by Winthrop Chemical Co., Inc. U. S. patent 808,748 (Jan. 2, 1906; expired). U. S. trademark 44,608, Tablets Alypin, H grain. Alypin is a white, crystalline powder, odorless, bitter and hygro- scopic. It is very soluble in water; freely soluble in alcohol and chloroform; insoluble in ether. Its aqueous solutions are neutral and are not rendered turbid on the addition of sodium bicarbonate solution in moderate quantities. Its aqueous solutions may be sterilized by boiling for a period not exceeding live minutes without decomposition. Two and four per cent aqueous solutions are quite stable, but weaker solutions are likely to become moldy. It should be protected from the air in well stoppered containers. With the aqueous solution (1 in 100) potassium dichromate solution produces an orange-yellow, crystalline precipitate, which is soluble in hydrochloric acid. Potassium permanganate solution produces a violet crystalline precipitate, which turns brown on standing. The aqueous solution of alypin (1 in 100) gives precipitates with potassium mercuric iodide solution, iodine solution, picric acid solution, gold chloride solution and many other alkaloidal reagents; it also gives precipitates with potassium iodide solution and mercuric chloride solution. Mix 0.1 Gm. of alypin with 1 cc. of sulfuric acid, warm the mixture to 100 C. for five minutes and carefully add 2 cc. of water: the odor of ethylbenzoate is developed. On cooling the mixture, crystals separate which are dissolved on adding 2 cc. of alcohol. Dry about 1 Gm. of alypin, accurately weighed, to constant weight at 100 C: the loss should not exceed 2 per cent. Incinerate about 0.5 Gm. of alypin, accurately weighed: the ash does not exceed 0.1 per cent. APOTHESINE. — Apothesine Hydrochloride. — 7-diethyl- aminopropyl cinnamate hydrochloride. (GH5)2N.CH2.CH2CH2. COO.CH : CH.CeH5.HCl. The hydrochloride of a condensa- tion product prepared by the action of cinnamoyl chloride on 7-diethylaminopropylalcohol. Actions and Uses. — Apothesine is a local anesthetic of the procaine rather than the cocaine type, that is, it belongs to that type which while effective for injection anesthesia (especially when combined with epinephrine), is relatively inefficient when applied to mucous membranes. It is rather slower in action than procaine hydrochloride. Its absolute toxicity is about equal ANESTHETICS 55 to that of cocaine but about twice that of procaine hydrochloride (as 20 is to 40). When injected, somewhat stronger solutions are required than are necessary with procaine hydrochloride, or especially with cocaine, but with adequate concentrations the anesthesia is just as complete. It is employed for infiltration injection, nerve blocking, intraspinal injection, pressure anes- thesia and oral administration as a palliative measure for its local anesthetic effect. Apothesine solutions are not injured by boiling. Dosage. — As a local anesthetic 0.5 to 2 per cent solution generally with epinephrine in sterile water or physiologic solu- tion of sodium chloride. For spinal anesthesia 2 cc. of a 4 per cent solution. Manufactured by Parke, Davis & Company, Detroit. U. S. patents 1,193,634; 1,193,649; 1,193,650, and 1,193,651 (Aug. 8, 1916; expired). Apothesine Solution: Each 100 cc. contains 1.5 Gm. of apothesine and 0.5 Gm. of chloretone (the latter is used as a preservative). Apothesine Hypodermic Tablets 0.08 Gm. (lH grains). Apothesine and Adrenalin Hypodermic Tablets: Each tablet contains apothesine 0.3 (jUI. (44-5 prains) and adrenalin 0.0003 Gm. VijOO grain), and not more than l/'^oo grain of sodium bisulphite. Apothesine and Adrenalin Hypodermic Tablets: Each tablet contains apothesine 0.039 Gm. (% grain) and adrenalin 0.00004 Gm. (Vieoo grain), and not more than y^OO grain of sodium bisulphite. Apothesine occurs in white masses which are composed of small white crystals, practically odorless and faintly bitter, but producing a sense of numbness of the tongue and permanent in the air. It is soluble in water and alcohol and slightly soluble in acetone or ether. Its aqueous solu- tion is neutral to litmus paper. The solution is stable. Aqueous solu- tions of apothesine produce precipitates with the alkali hydroxides and their carbonates (the precipitate formed with sodium bicarbonate is solu- ble in an excess of the reagent) and with the usual alkaloidal reagents. The free base of apothesine occurs as an oil; when heated with strong sodium hydroxide, it is decomposed to diethylaminopropylalcohol and sodium cinnamate. Apothesine melts at 136 C. An aqueous solution of apothesine gives, with silver nitrate solution, a white precipitate which is insoluble in nitric acid. Dissolve about 0.1 Gm. of apothesine in 5 cc. of water, add 2 drops of diluted hydrochloric acid and 2 drops of sodium nitrite solution (10 per cent) and mix with a solution of 0.2 Gm. of betanaphthol in 10 cc. of sodium hydroxide solution (10 per cent): a white precipitate is formed (distinction from ethyl aminobenzoate, which gives a cherry- red color in a solution containing undissolved benzocaine and from procaine hydrochloride, which gives a scarlet precipitate). Add a few drops of gold chloride solution to an aqueous solution of apothesine (1 in 100): a lemon-yellow precipitate is produced (distinc- tion from ethyl aminobenzoate and procaine hydrochloride which form brown precipitates). Dissolve about 0.1 Gm. of apothesine in 5 cc. of water, add 3 drops of diluted sulfuric acid and 5 drops of potassium permanganate solution: the violet color of the latter disappears immediately (distinc- tion from cocaine which gives a violet precipitate). Dissolve 0.1 Gm. of apothesine in 1 cc. of sulfuric acid: the solution remains colorless (organic impurities). Dissolve 0.1 Gm. of apothesine in 10 cc. of water and saturate the solution with hydrogen sulfide: no coloration or precipitation is pro- duced (salts of heavy metals). Incinerate about 0.5 Gm. of apothesine, accurately weighed: not more than 0.1 per cent of residue remains. 56 NEW AND NONOFFICIAL REMEDIES BENZYL ALCOHOL. — Alcohol Benzylicum. — Phen- methylol. — CeHs.CHoOH. — An aromatic alcohol occurring as an ester in tolu and other balsams ; the product on the market is produced synthetically. Actions and Uses. — Benzyl alcohol is used as a local anes- thetic by injection and by application to mucous membranes. It is practically nonirritant and nontoxic in the ordinary con- centrations and doses. Dosage. — Benzyl alcohol is usually used in the form of a 1 to 4 per cent solution in water or physiological solution of sodium chloride. Such solutions may be sterilized by boiling, without danger of decomposition. Pure benzyl alcohol is markedly antiseptic. The technic of injection is the same as for other local anesthetics. It is applied against pruritus as a 10 per cent ointment, in lard; or as a lotion of equal parts of benzyl alcohol, alcohol and water. Benzyl alcohol is a colorless liquid with a faint aromatic odor and a sharp burning taste. When placed on the tongue, it produces numb- ness, even if only a small quantity is used. It is soluble, 1 cc. in 25 cc. of water, and miscible in all proportions with alcohol, ether and chloroform. One volume of benzyl alcohol should dissolve in 1.5 volumes of 50 per cent alcohol. Benzyl alcohol boils without decom- position between 200 and 206 C. When ignited it burns with a smoky flame. It has a specific gravity of from 1.040 to 1.050 at 15 C. and 1.032 to 1.042 at 25 C. Benzyl alcohol is neutral to litmus. If 2 or 3 drops are added to a strong solution of potassium permanganate acidulated with sulfuric acid, rapid oxidation takes place and the odor of benzaldehyde is plainly evident. On heating the mixture, further oxidation takes place, and then by adding dilute sulfuric acid and decolorizing the mixture with hydrogen dioxide, benzoic acid may be obtained by extraction with ether. Wind the end of a copper wire to a spiral about 6.3 mm. (one-fourth inch) in diameter and length, and hold this spiral in a nonluminous flame until no green coloration is imparted to the flame; dip the spiral into the benzyl alcohol to be tested and burn off the adhering liquid outside the flame; place the nonluminous flame against a dark background and hold the loop in the right or left margin of the flame; not even a transient green coloration should be imparted to the flame (limit of chlorine compounds). If 5 cc. is shaken with 5 cc. of sodium hydroxide solution (5 per cent) and allowed to stand one hour, no yellow color should appear in the aqueous layer (aldehyde). Ten cc. of benzyl alcohol should leave no weighable residue on evaporation and heating until all carbon is burned away. Benzyl Alcohol-Seydel. — A brand of benzyl alcohol- N. N. R. Manufactured by The Seydel Chemical Company, Jersey City, N. J. No U. S. patent or trademark. BUTYN. — Butyn Sulfate. — />-Aminobenzoyl-7-dinormalbu- tylaminopropanol sulfate. — 7-dibutylaminopropvl-p-aminoben- zoate-A^-sulfate. — [NHo.aH4.COO(CH2)3.N(CH9)2.]2H2S04. Butyn is the normal sulfate of a base resembling the base of procaine hydrochloride (/'-aminobenzoyl-diethylaminoethanol hydrochloride) ; but it differs in that butyn possesses a butyl group in place of the ethyl group of procaine base, and a pro- panol group in place of the ethanol group. ANESTHETICS 57 Actions a)id Uses. — Butyn is a local anesthetic proposed as a substitute for cocaine, particularly in surface anesthesia, as for the eye, nose and throat. It has the special advantage of acting through intact mucosae about as effectively as cocaine. On the normal human eye, a 1 per cent solution of butyn sulfate is as effective as a 1 per cent solution of phenacaine hydro- chloride (holocaine), and more efficient than a 1 per cent solution of cocaine hydrochloride or a 1 per cent solution of eucaine. The instillation of butyn solutions often produces congestion of the conjunctiva, but this does not appear to be of practical significance. When butyn is injected hypodermically into albino rats, the toxicity is two and one-half times that of cocaine, but the lethal dose (injected intravenously into cats) is about equal to that of cocaine. Pharmacologic study indicates that butyn may take the place of cocaine, in whole or in part, for surface anes- thesia of mucous membranes and that it may be superior for tiiis purpose, especially for use in the eye, to other anesthetics, for the reason that it can be used in materially lower concen- trations (presumably because of more prompt absorption). On the other hand, it does not appear promising for injection anesthesia or for spinal anesthesia, since its toxicity is materi- ally greater than that of procaine hydrochloride ; but butyn is used for injection anesthesia, in concentrations of 0.1 to 0.4 per cent. A committee of the Section of Ophthalmology of the Ameri- can Medical Association (/. A. M. A. 78:343 [Feb. 4] 1922) reported the successful use of butyn in practically all operations on the eye and in some operations on the nose and throat. The committee concluded that butyn is more powerful than cocaine, a smaller quantity being required ; that it acts more rapidly than cocaine, and that the action is more prolonged. So far as the experiences of the committee go, butyn in the quantity required is less toxic than cocaine. The committee found butyn superior to cocaine in that it produces no drying of the tissues and no change in the size of the pupil and that it has no ischemic effect. Dosage. — For ophthalmologic work, butyn is generally used in 2 per cent solutions. A single application produces, within one minute, an anesthesia sufficient to permit the removal of superficially placed foreign bodies, the application of irritant astringents and the use of the tonometer. Four instillations, three minutes apart, permit operative work within five minutes after the last instillation, producing an anesthesia sufficient to perform all of the commoner operations on the eye. For topical use in nose and throat work, a 2 per cent solution is usually employed. Butyn solutions may be sterilized by boiling. Manufactured by the Abbott Laboratories, North Chicago, 111. U. S. patent 1,358,751 (Nov. 16, 1920; expires 1937). U. S. trademark 147,893. Butyn Solution, 2 per cent. Butyn Tablets, 0.2 Gm. (3 grains). 58 NEW AND NONOFFICIAL REMEDIES Butyn and Epinephrin Hypodermic Tablets: Butyn 0.01 Gm, (^ grain), epinephrin-Abbott, 0.032 mg. (V^oo grain). Ophthalmic Ointment Butyn 2% and Metaphen 1:3,000: Contains 2 per cent of butyn with metaphen 1 : 3,000 in a base of petrolatum. Butyn is a colorless, odorless, solid which rapidly produces a sense of numbness when placed upon the tongue. It melts at from 98 to 100 C. Butyn is soluble in less than its own weight of water at 20 C. It dissolves slowly in cold water, but rapidly in hot water. It is very soluble in warm alcohol and in acetone, from which it does not readily separate on cooling. It is slightly soluble in chloroform, and insoluble in ether. From aqueous solutions of butyn, alkali hydroxides and carbonates, precipitate the free base as a colorless oil : the soluble bicarbonates pre- cipitate a crystalline butyn carbonate. When the separated base is exactly neutralized with hydrochloric acid, the white hydrochloride crystallizes out; after drying at 100 C, these crystals melt at 151 C. Dissolve one gram of butyn in 10 cc. of water: separate portions of the solution yield a white precipitate with potassium mercuric iodide solution; a brown precipitate with iodine solution; a brown precipitate with gold chloride solution and a yellow precipitate with picric acid solution; a portion to which barium chloride solution is added gives a white precipitate (distinction from procaine hydrochloride). Dissolve about 0.1 Gm. of butyn in 5 cc. of water, add 2 drops of diluted hydrochloric acid and 2 drops of sodium nitrite solution (10 per cent) and mix with a solution of 0.2 Gm. of betanaphthol in 10 cc. of sodium hydroxide solution (10 per cent): a scarlet red precipitate is formed (distinction from phcnacaine, which gives a white precipitate). To a solution of about 0.1 Gm. of butyn in 5 cc. of water, add 3 drops of diluted sulfuric acid and mix with 5 drops of potassium permanganate solution: the violet color of the latter disappears immedi- ately {distinction from cocaine). Dissolve about 0.1 Gm. of butyn in 1 cc. of sulfuric acid: the solution is colorless (organic impurities). Dissolve 0.1 Gm. of the salt in 10 cc. of water and saturate with hydrogen sulfide: no coloration or precipitation occurs (salts of heavy metals). Incinerate about 0.5 Gm. of butyn, accurately weighed: there is not more than 0.2 per cent residue. Butyn Ointment-M. E. S. Co.: Butyn, 1 per cent; water, 1 per cent; wool fat 5 per cent and petrolatum, sterile, 93 per cent. Put up in collapsible tubes for application to the eye. Prepared by Manhattan Eye Salve Co., Louisville, Ky. DIOTHANE HYDROCHLORIDE.— Diothaiie.—Piperi- dinopropanediol-cf/-phenvIurethane hydrochloride. — C5H10N.CH2 CHCOCONHCeHs) CH2(OCONHC6H5).HCl. — The hydro- chloride of the base piperidino-propanediol-(f/-phenylurethane, obtained by combining piperidine and glycerol monochlorohy- drin in the presence of an alkali, and reacting the piperidinopro- panediol with phenyl uocyanate. Actions and Uses. — Nearly similar to those of cocaine, but it is claimed that the anesthesia lasts somewhat longer than that induced by corresponding doses of cocaine hydrochloride or procaine hydrochloride. Its toxicity by intravenous injection is about three times that of procaine hydrochloride and hence it should not be injected except in very small amounts. ANESTHETICS 59 Solutions of diothane hydrochloride prepared extemporaneously should be used promptly, since such solutions usually contain traces of alkali and are thereby subject to precipitation. Manufactured by the Wm. S. Merrell Company, Cincinnati, U. S. patent 2,004,132 (June 11, 1935; expires 1952). U. S. trademark 296,850. Ampules Diothane Hydrochloride Solution in Solution of Sodium Chloride 0.6%, 6 cc. Diothane Ointment, 1% : An aqueous solution of diothane hydro- chloride, 1 per cent, in an oxycholesterin base. Diothane Ointment 1% in Ophthalmic Tube: Collapsible tubes con- taining an aqueous solution of diothane hydrochloride, 1 per cent, in an oxycholesterin base. Diothane Solution, 1% : A solution of diothane hydrochloride, 1 per cent, in distilled water. Diothane hydrochloride occurs as a fine, white crystalline, odorless powder; when applied to the tongue, it possesses a bitter taste followed by a sense of numbness; permanent in the air at ordinary tempera- tures; slightly soluble in water, acetone and ethyl acetate; soluble in alcohol; insoluble in benzene and ether. Its aqueous solution (1 in 100) is faintly acid to litmus. Diothane hydrochloride melts at 195 to 200 C., with decomposition. From aqueous solutions, alkali carbonates and hydroxides precipitate the free base as a colorless oil, which does not solidify under ordinary conditions. Dissolve about 0.5 Gm. of diothane hydrochloride in 50 cc. of water; separate portions of 5 cc. each: to one portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in an excess of ammonia water; to another portion add 0.2 cc. of diluted hydrochloric acid. 0.2 cc. of a 10 per cent solution of sodium nitrite and gradually mix with a solution of 0.2 Gm. of betanaphthol in 10 cc. of a 10 per cent sodium hydroxide solution: a white, changing to a yellowish and finally to an orange color appears, increasing in intensity as the concentration of the betanaphthol becomes greater (distinction from the anesthetics responding to the diazo-reaction) ; to another portion add 5 drops of gold chloride solution: an orange-yellow precipitate appears {distinc- tion from alypin, apothesine, cocaine, metycaine and nupercaine, which give a lemon-yellow precipitate and butyn, procaine and tutocaine, which yield brown precipitates). Dissolve about 0.1 Gm. of diothane hydrochloride in 1 cc. of sulfuric acid: the solution is colorless (readily carbonizable substances). Saturate about 0.1 Gm. of diothane hydrochloride dissolved in 10 cc. of water with hydrogen sulfide: no coloration or precipitation results {salts of heavy metals). Dry about 0.5 Gm. of diothane hydrochloride, accurately weighed, at 100 C. for six hours: the loss in weight does not exceed 0.5 per cent. Incinerate about 0.5 Gm. of diothane hydrochloride, accurately weighed: the residue is not more than 0.1 per cent. Transfer about 0.3 Gm. of diothane hydrochloride, accurately weighed, to a 500 cc. Kjeldahl flask, and determine the nitrogen content according to the official method described in Official and Tentative Methods of Analysis of the Association of Official Agricultural Chemists, third edition, page 20, chapter 2, paragraph 22: the percentage of nitrogen corresponds to not less than 9.5 per cent, nor more than 9.8 per cent when calcu- lated to the dried substance. Dissolve about 0.25 Gm. of diothane hydrochloride, accurately weighed, in 25 cc. of water, by warming, and transfer to a suitable Squibb separatory funnel, rinse twice using about 10 cc. of water, followed by the addition of 3 cc. of a diluted ammonia water (one part of ammonia water and ten parts of water), extract with four successive portions of ether using 20 cc. each; filter through a pledget of cotton and evaporate to a thick oil in a stream of warm air; dissolve the oily residue in about 25 cc. of previously neutralized alcohol; warm slightly; add 10 cc. of tenth-normal hydro- chloric acid solution, followed by the addition of 10 cc. of water; determine the excess of acid by titration with tenth-normal sodiu n hydroxide solution, using bromphenol blue as an indicator: the amount of tenth-normal hydrochloric acid consumed corresponds to not less than 90.5 per cent nor more than 92 per cent of piperidinopropanediol- dt-phenylurethane when calculated to the dried substance. Transfer the 60 NEW AND NONOFFICIAL REMEDIES ammoniacal aqueous portion from the foregoing immiscible solvent extraction to a 400 cc. beaker and place on the steam-bath for three hours; add 100 cc. of water, followed by the addition of 10 cc. of nitric acid and 25 cc. of silver nitrate solution; subsequently boil with con- tinuous stirring and allow to cool in a dark place. Collect the pre- cipitate of silver chloride on a Gooch crucible, wash with diluted nitric acid and water, followed by alcohol and ether; finally dry to constant weight at 105 C; the amount of hydrogen chloride calculated from the silver chloride found corresponds to not less than 8.35 per cent, nor more than 8.45 per cent when calculated to the dried substance. LAROCAINE HYDROCHLORIDE. — ^aminobenzoyl- 2-2-dimethyl-3-diethylaminopropanol hydrochloride. — 7-diethyl- amino-i3-i3-dimethylpropyl-/'-aminobenzoate hydrochoride. — NH2(C6H4CO)OCHoC(CH3).CH2N(C2H5)2.HCl. The base of larocaine belongs to the procaine type. It differs from pro- caine in having a propanol group instead of the ethanol group and has two methyl groups attached to the former. Actions and Uses. — Larocaine hydrochloride acts as a surface as well as a conduction (infiltration) anesthetic and compares quite favorably in both fields with either cocaine or procaine. Larocaine hydrochloride is quick in action and produces anes- thesia of a somewhat longer duration than cocaine or procaine. The average duration of conduction anesthesia is from three to five hours, Larocaine hydrochloride is non-narcotic and non-habit forming. Dosage. — For corneal and conjunctival anesthesia, from 2 to 5 per cent solutions may be used. In otorhinolaryngology, 5 to 10 per cent solutions have been employed. From 0.75 to 1 per cent solutions are used in urology. For conduction anes- thesia, 0.25 to 2 per cent solutions may be used. Solutions of larocaine hydrochloride may be sterilized by boiling for ten minutes. Epinephrine when desired may be added just prior to administration. Stock solutions should be kept in dark- bottles. The product is supplied in vials containing %, ^/i, y2 and 1 ounce of larocaine hydrochloride in powder form. Manufactured by F. Hoffmann-LaRoche & Co., Basle, Switzerland (Hoffmann-LaRoche, Inc., Nutley, N. J., distributor). U. S. patent 1,824,676 (Sept. 22, 1931; expires, 1948). U. S. trademark 283,775. Larocaine hydrochloride occurs as a fine white, odorless, crystalline powder; when applied to the tongue, it possesses a bitter taste followed by a sense of numbness; permanent in the air at ordinary tempera- tures; freely soluble in water; soluble in alcohol: sparingly soluble in chloroform, insoluble in ether. Its aqueous solution is faintly acid to litmus. Larocaine hydrochloride melts at 196-197 C, with decom- position. From aqueous solutions, alkali carbonates and hydroxides precipitate the free base as a colorless oil, which solidifies after a time at ordinary temperature. Dissolve about 0.05 Gm. of larocaine hydrochloride in 50 cc. of water; separate portions of 5 cc. each; to one portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in an excess of ammonia water; to another portion add 0.2 cc. of diluted hydro- chloric acid, 0.2 cc. of a 10 per cent solution of sodium nitrite and gradually mix with a solution containing 0.2 Gm. of betanaphthol dis- solved in 10 cc. of a 10 per cent sodium hydroxide solution: a red precipitate is formed (distinction from the anesthetics not responding to the diazo reaction); to another portion add 0.3 cc. of diluted sulfuric ANESTHETICS 61 acid, followed by the addition of 0.5 cc. of tenth-normal potassium permanganate solution: the red coloration disappears immediately (dis- tinction from cocaine and some other local anesthetics) . Dissolve about 0.1 Gm. of larocaine hydrochloride in 1 cc. of sulfuric acid: the solution is colorless {readily carbonisable substances). Saturate about 0.1 Gm. of larocaine hydrochloride dissolved in 10 cc. of water with hydrogen sulfide: no coloration or precipitation results (salts of heavy metals). Dry about 0.5 Gm. of larocaine hydrochloride, accurately weighed, at 100 C., for six hours: the loss in weight does not exceed 1 per cent. Incinerate about 0.5 Gm. of larocaine hydrochloride, accurately weighed: the residue is not more than 0.1 per cent. Transfer about 0.3 Gm. of larocaine hydrochloride, accurately weighed, to a 500 cc. Kjeldahl flask and determine the nitrogen content according to the official method described in Official and Tentative Methods of Analysis of the Association of Official Agricultural Chemists, third edition, page 20, chapter 2, paragraph 22: the percentage of nitrogen corresponds to not less than 8.8 per cent, nor more than 9 per cent when calculated to the dried substance. Transfer about 0.3 Gm. of larocaine hydro- chloride, accurately weighed, to a suitable Squibb separatory funnel. add 25 cc. of water, followed by the addition of 5 cc. of ammonia water; extract with seven successive portions of ether using 35 cc, 30 cc, 25 cc, 25 cc, 20 cc, 15 cc. and 10 cc, respectively; wash the combined ethereal solution with 15 cc. of water, filter through a pledget of cotton and evaporate to a thick oil in a stream of warm air; expose over sulfuric acid in a partially exhausted desiccator; dissolve the oily residue in about 20 cc. of previously neutralized alcohol; warm slightly; add 12.5 cc. of tenth-normal hydrochloric acid solution, followed by the addition of an equal volume of water; determine the excess of acid by titration with tenth-normal sodium hydroxide solu- tion, usin^ methyl red as an indicator: the amount of tenth-normal hydrochloric acid solution consumed corresponds to not less than 87 per cent nor more than 89 per cent aminobenzoyldimethyldiethylamino propanol, when calculated to the dried substance. Transfer the ammoniacal aqueous portion from the immiscible solvent extraction to a 400 cc. beaker and place on the steam bath for three hours, add 100 cc. of water, followed by the addition of 10 cc. of nitric acid and 25 cc. of silver nitrate solution, subsequently boil, with continuous stirring and allow to cool in a dark place. Collect the precipitate of silver chloride on a Gooch crucible, wash with a diluted nitric acid and water, followed by alcohol and ether; finally dry to constant weight at 105 C. : the amount of hydrogen chloride calculated from the silver chloride found corresponds to not less than 11.5 per cent nor more than 11,7 per cent when calculated to the dried substance, METYCAINE.— Metycaine Hydrochloride.— Benzoy 1-7- (2- methylpiperidino) -propanol hydrochloride. — 7 - (2-methylpiperi- dino)-propylbenzoate hydrochloride. — C6H4.COO(CH2)3.NC8Hio. HCl. — The base of metycaine differs from the base of procaine hydrochloride in having the basic nitrogen in a methylpiperidino ring instead of the dimethylamine, a propanol group in place of the ethanol group and in not having an amino group attached to the benzene ring. In addition, it possesses an asymmetric carbon atom and is optically inactive. Metycaine is therefore a racemic mixture of the hydrochlorides. Actions and Uses. — Metycaine is a local anesthetic which produces prompt anesthesia either by subcutaneous injection or topical application to mucous membranes and similar surfaces. Pharmacologic studies on animals indicate that the toxicity of metycaine following subcutaneous injection is lower than that of cocaine and comparable to that of procaine ; intravenously, it was found to be approximately three times as toxic as procaine. 62 NEW AND NONOFFICIAL REMEDIES Dosage. — For application to the eye metycaine is used in 2 per cent solutions ; for nose and throat, 2 to 10 per cent solutions are used ; 1 to 4 per cent solutions have been used for urethral anesthesia ; for infiltrative anesthesia in small areas, solutions of 0.5 to 1 per cent are generally used. Manufactured by Eli Lilly & Co., Indianapolis, Ind. U. S. patent 1,784,903 (Dec. 16, 1930; expires 1947). U. S. trademark 305,894. Ampoules Metycaine 1%, 1 cc: Each cc. contains metycaine 0.01 Gm. (J^ gr.), in physiological solution of sodium chloride. Ampoules Metycaine 2% and Epinephrine (1: 25,000), 1 cc: Each cc. contains metycaine 0.01 Gm. {]/(, gr.), epinephrine 0.04 mg. (Vieoo gr.), and thiourea 0.3%, in Ringer's solution. The thiourea, which is added to the dosage forms containing epinephrine in order to prevent oxidation, complies with the following standards: It is a white, crystalline, almost odorless solid; soluble in water and hot alcohol and slightly soluble in cold alcohol, chloroform, and ether. When 0.05 Gm. is dissolved in 10 cc. of water to which 2 drops of ferric chloride solution have been added, the color is only slightly augmented (sulfocyanates). Warm 0.05 Gm. of thiourea in a test tube until it melts, cool, add 10 cc. of water and 2 drops of ferric chloride solution: a blood red color results. Add 10 cc. of water and 4 cc. of diluted nitric acid to a mixture of 0.1 Gm. bismuth nitrate and 0.3 Gm. of thiourea, and warm; an orange colored solution results, which upon evaporation yields crystals of an orange color. The melting point of thiourea ranges from 176 to 180 C. Ampoules Metycaine 2% and Epinephrine (1:50,000), 2.5 cc. : Each cc. contains metycaine 0.02 Gm. (^ gr.), epinephrine 0.02 mg. (^^200 gr.), and thiourea 0.15% in Ringer's solution. Metycaine Ophthalmic Ointment 4 per cent: Metycaine 4 per cent, in a base consisting of liquid petrolatum and wool fat, with small amounts of paraffin, white petrolatum and ceresin. Solution Metycaine 2%: Metycaine 2% in physiological solution of sodium chloride containing chlorbutanol 0.5% as preservative. Tablets Metycaine, 0.15 Gm. Tablets Metycaine, J/^ grain. Metycaine occurs as a fine, white, crystalline, odorless powder; when applied to the tongue, it possesses a slightly bitter taste followed by a sense of numbness; permanent in the air; freely soluble in water, about 1 in 1 ; soluble in alcohol and chloroform; insoluble in ether and olive oil. Its aqueous solution (1 in 10) is faintly acid to litmus. It is optically inactive. Metycaine melts at from 171 to 173 C. From aqueous solutions, alkali carbonates and hydroxides precipitate the free base as a water-white to a light yellowish oil which does not solidify at ordinary temperatures. Dissolve about 1 Gm. of Metycaine in 10 cc. of water; divide into portions of 2 cc; to one portion add 1 cc. of diluted sulfuric acid and 1 cc. of potassium permanganate solution: the color is discharged (distinction from alypin, which gives a violet crystalline precipitate and soon disappears) ; to a second portion add 1 cc. of gold chloride solution: a yellow precipitate appears (distinction from apothesine, which gives a lemon-yellow precipitate) ; to a third portion add 2 drops of diluted hydrochloric acid, 2 drops of a 10 per cent sodium nitrite solution and gradually mix with a solution of 0.2 Gm. of beta-naphthol in 10 cc. of a 10 per cent sodium hydroxide solution: a white, changing to a yellowish, and finally to a greenish yellow color appears, increasing in intensity as the concentration of the beta-naphthol becomes greater (distinction from the anesthetics responding to the diasoreaction, Warren, L. E., The Identification of Some Local Anesthetics, Jour. Amer. Phar. Assn., 13:512). Dissolve about 0.1 Gm. of metycaine in 1 cc. of sulfuric acid: the solution is colorless (readily carbonizable substances) . Dissolve about 0.5 Gm. of metycaine in 50 cc. of water: separate portions of 5 cc. each yield no turbidity with 1 cc. of diluted hydrochloric acid and 1 cc. of barium chloride solution (sulfate); no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). ANESTHETICS 63 Dry about 0.5 Gm. of metycaine, accurately weighed, over sulfuric acid in a desiccator for 48 hours: the loss does not exceed 0.25 per cent. Incinerate about 0.5 Gra. of metycaine, accurately weighed: the residue is not more than 0.2 per cent. Transfer about 0.25 Gm. of metycaine to a 400 cc. beaker, add 100 cc. of water, followed by the addition of 25 cc. of tenth-normal silver nitrate solution and 10 cc. of nitric acid, boil with continuous stirring and allow to cool in a dark place. Collect the precipitate of silver chloride on a Gooch crucible, wash with nitric acid and water, followed by alcohol and ether; finally dry to constant weight at 105 C.: the amount of hydrogen chloride talculated from the silver chloride found corresponds to not less than 12 per cent, nor more than 12.35 per cent calculated to the dried substance. Transfer about 0.25 Gm. of metycaine, accurately weighed, to a suitable Squibb separatory funnel, add 50 cc. of water, followed by the addition of 5 cc. of ammonia water, extract with seven suc- cessive portions of chloroform, using 35 cc, 30 cc, 25 cc, 20 cc, 15 cc, 10 cc, and 10 cc, respectively; wash the combined chloroformic solution with 15 cc. of water, filter through a pledget of cotton and evaporate to a thick oil in a stream of warm air; expose over sulfuric acid in a partially exhausted desiccator; dissolve the oily residue in about 10 cc. of previously neutralized alcohol; warm slightly; add 10 cc. of tenth-normal hydrochloric acid solution, followed by the addition of an equal volume of water; determine the excess of acid by titration with twentieth-normal sodium hydroxide solution, using methyl-red as an indicator : the amount of tenth-normal hydrochloric acid solution consumed corresponds to not less than 86.5 per cent, nor more than 88 per cent benzoyl-7-(2-methylpiperidino) propanol. NUPERCAINE-CIBA. — Nupercaine Hydrochloride. — a-butyloxycinchoninic acid, 7-diethylethylenediamide hydro- chloride. — 2-butyloxyquinolinecarboxylic acid-4-diethylethylene- diamide hydrochloride. C9H5N.OC4H9(2).CONH(CH2)2N (C2H5)2HC1(4). — The hydrochloride of the base a-butyloxycin- choninic acid 7-diethylethylenediamide obtained by chlorination of a-chlor-cinchoninic acid chloride and conversion of the latter with asymmetric diethylethylenediamine into a-chlor-cinchoninic acid diethylethylenediamine and subsequent heating with sodium butylate. Nupercaine was introduced as percaine. Actions and Uses. — Nupercaine is a local anesthetic, acting like cocaine when applied to mucous surfaces and like procaine or cocaine when injected, the action being relatively prolonged. Nupercaine is about five times as toxic as cocaine when it is injected intravenously into animals, and its anesthetic activity is correspondingly greater than that of cocaine when it is applied to a mucous surface ; it is many times more active than procaine hydrochloride when it is injected subcutaneously. It is reported to have caused necrosis of tissue in one case and a condition resembling gangrene with recovery in another. Death has been reported after the subcutaneous injection of 135 cc. of a solution of 1 in 1,000. Weak solutions (1 in 2,000) cause slight tem- porary vascular dilatation (avoided by the addition of epi- nephrine hydrochloride), followed by constriction. The usual precautions should be observed when it is injected into the spinal canal or into the urethra. Dosage. — For infiltration anesthesia solutions of from 1 in 2,000 to 1 in 1,000, with the addition of 0.1 cc. of epinephrine hydro- chloride solution (1 in 1,000) to 100 cc. of the solution. Not more than 100 cc. of 1 in 1,000 solution should be injected. For spinal 64 NEW AND NONOFFICIAL REMEDIES anesthesia, a total of from 7.5 to 10 mg. (Ys to ^ grain) in 1 in 200 solution; for sacral anesthesia, 25 to 35 cc. (about 1 fluidounce) of 1 in 1,000 solution or a correspondingly smaller volume of 1 in 500 solution. The details of dosage should be learned with reference to various modifications for different applications. Aqueous solutions of nupercaine should be pre- pared with distilled water, as the salts present in tap water of many localities may precipitate the free base, butyloxycincho- ninic acid diethylethylenediamide. Alkali-free glass should be used in the preparation of its solutions. Manufactured by the Society of Chemical Industry in Basle, Switzei land (Ciba Company, Inc., New York, distributor). U. S. paten 1.825,623. U. S. trademark 266,366. Ampules Buffered Solution of Nupercainc-Ciba 2 cc, 1 : 200. Ampules Solution of Nupercaine-Ciba 5 cc, 1:1,000. Ampules Solution of Nupercaine-Ciba 25 cc, 1 : 1,000. Solution of Nupercaine-Ciba, 2%. Tablets Nupercaine-Ciba, 50 mg. Nupercaine occurs as fine, white, crystalline, odorless powder; hygro- scopic; very soluble in water, about 2 in 1, freely soluble in alcohol, soluble in acetone and chloroform, slightly soluble in benzene, ethyl acetate and toluene on warming, but with difficulty in the cold, its aqueous solution, about 1 in 20, is faintly alkaline to litmus, producing a definite anesthesia on the tongue. Nupercaine "melts" at 90 to 98 C. Transfer about 0.5 Gm. of nupercaine to a suitable Squibb separate ry funnel, add 25 cc of vyater, followed by the addition of 2 cc. normal sodium hydroxide solution and extract with three successive portions of purified petroleum benzin, using 25 cc, 20 cc. and 10 cc, respec- tively; evaporate the combined petroleum benzin extractions to dryness: the crystals melt at not less than 64 C. Nupercaine-base fluoresces with the more common oxygen containing acids. Dissolve about 0.5 Gm. of nupercaine in 50 cc. of water, add 0.2 Gm. of potassium perchlorate previously dissolved in 25 cc. of water and allow to stand several hours: the crystals of nupercaine perchlorate crystallized from water melt at 130 to 132 C. Dissolve about 0.5 Gm. of nupercaine in 50 cc. of water: separate portions of 10 cc. each yield a white precipitate on the addition of 1 cc. of nitric acid and 2 cc. of silver nitrate which after decantation of the supernatant is soluble in an excess of ammonia water; no turbidity with 1 cc. of diluted hydrochloric acid and 1 cc. of barium chloride solution (sulfate) ; no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Dry about 0.5 Gm. of nupercaine, accurately weighed, over sulfuric acid in a desiccator for forty-eight hours: the loss does not exceed 2.5 per cent. Incinerate about 0.5 Gm., accurately weighed: the residue is not more than 0.1 per cent. Transfer about 0.5 Gm. of nupercaine to a 400 cc. beaker, add 75 cc. of water, followed by the addition of 25 cc. of tenth-normal silver nitrate solution and 10 cc. of nitric acid, subsequently boil, with continuous stirring and allow to cool in a dark place. Collect the precipitate of silver chloride in a Gooch crucible, wash with nitric acid and water, followed by alcohol and ether; finally dry to constant weight at 105 C: the amcmnt of hydrogen chloride calculated from the silver chloride found corresponds to not less than 9.5 per cent nor more than 9.7 per cent, calculated to the dried sub- stance. Transfer about 0.3 Gm. of nupercaine-Ciba, accurately weighed, to a suitable Squibb separatory funnel, add 50 cc of water, followed by the addition of 2 cc. of normal sodium hydroxide solution, extract with six successive portions of chloroform, using 50 cc, 25 cc, 20 cc, 15cc., 10 cc. and 10 cc, respectively, wash the combined chloroformic solution with 15 cc. of water and evaporate to a thick oil in a stream of warm air; expose over sulfuiic acid in a partially exhausted desiccator; dissolve the oily residue in about 10 cc. of previously neutralized alco- hol; warm slightly; add 10 cc. of tenth-normal hydrochloric acid solution, followed by the addition of an equal volume of water; determine the ANESTHETICS 65 excess of acid by titration with fiftieth-normal sodium hydroxide solution, using methyl red as an indicator: the amount of tenth-normal hydro- chloric acid solution consumed corresponds to notless than 88.5 per cent nor more than 90.5 per cent butyloxycinchoninic acid diethylethylene- diamide, calculated to the dried substance. PHENACAINE HYDROCHLORIDE.— CH3C :(NC6H4 OC2H5).(NH.GH40GHo).HCl+H,0. "The hydrochloride of ethenyl-p-diethoxydiphenylamidine." U. S. P. For standards see the U. S. Pharmacopeia under Phenacainae Hydrochloridum. Actions and Uses. — Phenacaine hydrochloride is a local anes- thetic like cocaine but having the advantage of a quicker effect. Five minims of a 1 per cent solution when instilled into the eye is usually sufficient to cause anesthesia in from one to ten minutes. This is preceded by temporary smarting. Dosage. — It is applied in a 1 per cent aqueous solution. Phenacaine hydrochloride is incompatible with alkalis and their carbonates and the usual alkaloidal reagents. Glass vessels should be avoided in preparing the solution, porcelain being used instead. The solutions are permanent, as the drug is itself antiseptic. They are not injured by boiling. Holocaine Ointment-M. E. S. Co.: Holocaine, 1 per cent; water, 1 per cent; wool fat, 5 per cent and petrolatum, sterile, 93 per cent. Put tip in collapsible tubes, for application to the eye. Prepared by Manhattan Eye Salve Co., Louisville, Ky. Holocaine and Adrenalin Ointment-M. E. S. Co.: Composed of holo- caine, 1 per cent; adrenalin chloride solution, 2 per cent; water, 1 per cent; wool fat, 10 per cent; white petrolatum, sterile, 86 per cent. Put up in collapsible tubes, for application to the eye. Prepared by Manhattan Eye Salve Co., Louisville, Ky. Holocaine. — Holocaine Hydrochloride. — A brand of phena- caine hydrochloride-U. S. P. Manufactured by Winthrop Chemical Co., Inc., New York. No U. S. patent. Holocaine Solution, 1 per cent: An aqueous solution containing holo- caine hydrochloride 1 per cent, for ocular anesthesia by instillation. The product is not to be used for injection. Phenacaine-Werner. — Phenacaine Hydrochloride. — A brand of phenacaine hydrochloride-U. S. P. Manufactured by the Werner Drug and Chemical Company, Cincinnati, Ohio. No U. S. patent or trademark. PROCAINE BORATE. — l-amino-benzoyl-2-diethylamino ethanol-penta-;n-borate ; ^-diethylaminoethvl-/5-amino-benzoate penta 7«-borate. C6H.NH2COO.GH4N(C2H5)2.5HBO.. — A borate formed by the interaction of />-aminobenzoyl-diethylamino- ethanol (procaine base) and boric acid in the same organic solvent. Procaine borate contains 51.8 per cent of /^-amino- benzoyl-diethylaminoethanol. Actions and Uses. — Procaine borate closely resembles pro- caine hydrochloride in its actions and uses. The molecule is 66 NEW AND NONOFFICIAL REMEDIES heavier than that of procaine hydrochloride, but the toxicity and the anesthetic activity are closely proportional to the pro- caine base which they contain. When injected subcutaneously, procaine borate exerts a prompt and powerful anesthetic action. It is nonirritant. The testimony concerning its activity when applied to mucous membranes lacks uniformity. Dosage. — For infiltration anesthesia, solutions of 0.5 to 1 per cent; for blocking nerves, from 1 to 2 per cent; for tonsillec- tomy, 0.5 to 1 per cent; mucous surfaces, 2 to 20 per cent, dependent on the location and the depth of anesthesia required. Its action is enhanced by the addition of a small amount of epinephrine, as in the case of procaine hydrochloride. Owing to the smaller content of the base in procaine borate, the total dose may exceed that of procaine hydrochloride by about 50 per cent. Procaine borate occurs as a fine, white, odorless, crystalline powder; when applied to the tongue, it possesses a slightly bitter taste, followed by a sense of numbness; permanent in air; freely soluble in water, about 1 in 4, soluble in alcohol; insoluble in acetone, benzene, chloro- form and ether. Its aqueous solution (1 in 10) is alkaline to litmus, dissociating hydrolytically. Procaine borate "melts" at 163 to 166 C. Transfer about 1 Gm. of procaine borate to a suitable Squibb sepa- ratory funnel, add 25 cc. of water, followed by the addition of 5 cc. of normal sodium hydroxide solution and extract with 3 successive portions of chloroform using 25 cc, 20 cc. and 10 cc, respectively; evaporate the combined chloroformic solutions to dryness, dissolve the oily semisolid base in 25 cc. of a 2 per cent solution of hydrochloric acid: portions of the solution respond to the tests for procaine hydro- chloride, U. S. P. XI, p. 306. Dissolve 0.1 Gm. of procaine borate in 2 cc of methyl alcohol, add 5 drops of sulfuric acid and ignite the mixture: a green mantle is imparted to the flame. Dissolve 0.5 Gm. of procaine borate in 50 cc. of water: separate portions of 10 cc. each yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution (chloride) ; no turbidity with 1 cc. of diluted hydrochloric acid and 1 cc. of barium chloride solution (sulfate) ; no coloration or precipitation on saturation with hydrogen sulfide {salts of heavy metals). When tested for arsenic according to the U. S. Pharmacopeia XI, the product should meet requirements for the arsenic (p. 436, Arsenic Test). Transfer about 0.5 Gm., procaine borate, accurately weighed, to a 50 cc. glass stoppered cylinder, add 25 cc. of chloroform and shake the cylinder and contents for five minutes; allow to stand until the insoluble portion separates; filter, wash the cylinder and the insoluble material onto the filter with two portions of chloro- forrn, using 15 cc. and 10 cc, respectively, adding the washings to the original filtrate; evaporate the combined filtrates to dryness in a tared beaker and dry to constant weight over sulfuric acid in a par- tially exhausted desiccator: the oily residue should not exceed 2 per cent (limit of uncombined p-aminobenzoyl-diethylaminoethanol). Dry about 1 Gm. of procaine borate, accurately weighed, over sul- furic acid in a partially exhausted desiccator for forty-eight hours: the loss does not exceed 2 per cent. Transfer about 0.4 Gm. of pro- caine borate, accurately weighed, to a suitable Squibb separatory funnel, add 25 cc. of water, followed by the addition of 2 cc. of normal sodium hydroxide solution, extract with six successive portions of chloroform, using 25 cc, 20 cc, 15 cc, 10 cc, 10 cc and 10 cc, respectively, evaporate the combined chloroformic solutions to dryness in a stream of warm air, and dry to constant weight over sulfuric acid in a par- tially exhausted desiccator; dissolve the oily residue in about 10 cc. of previously neutralized alcohol, add 10 cc of tenth-normal hydrochloric acid solution, followed by the addition of an equal volume of water; determine the excess of acid by titration with fiftieth-normal sodium hydroxide solution, using methyl red as an indicator: the amount of ANESTHETICS 67 lenth-normal hydrochloric acid solution consumed corresponds to not less than 50.0 per cent nor more than 52.0 per cent, /'-amino-benzoyl- diethylamino-ethanol, calculated to the dried substance. Transfer about 0.4 Gm. of procaine borate to a steam distillation apparatus and determine the »)?-boric acid according to the Gladding method of distil- lation and subsequent titration (See Leach, Food Inspection and Analysis, ed. 4, p. 884) : the amount of tenth-normal sodium hydroxide solution consumed corresponds to not less than 47.0 per cent nor more than 48.5 per cent, «i-boric acid (HBO2), calculated to the dried substance. Procaine Borate-Searle. — A brand of procaine borate- N. N. R. Manufactured by G, D. Searle & Co., Chicago. No U. S. patent or trademark. Tablets Procaine Borate and Epinephrine: Each tablet contains pro- caine borate-Searle 0.05 Gm. (^ grain) and epinephrine 0.0001 Gm. ('/640 grain). Tablets Procaine Borate without Epinephrine: Each tablet contains procaine borate-Searle 0.05 Gm. (M grain). PROCAINE HYDROCHLORIDE. — Procaine.— "Para- aminobenzoyl-diethylaminoethanol hydrochloride."-f/. 5*. P. For standards see the U. S. Pharmacopeia under Procainae Hydrochloridum. Actions and Uses. — Procaine hydrochloride is a local anes- thetic, less toxic than cocaine and most other cocaine sub- stitutes. When injected subcutaneously it exerts a prompt and powerful anesthetic action, but the effect is not sustained. This may be remedied by the simultaneous injection of epinephrine. Procaine hydrochloride is only slightly irritant. It is relatively ineffective w^hen applied to intact mucous membranes. Dosage. — For infiltration anesthesia, solutions of 0.25 Gm. (4 grains) procaine hydrochloride in 50 or 100 cc. (1.6 or 3.2 ounces) physiological solution of sodium chloride, with 0.3 or 0.6 cc. (5 or 10 minims) of epinephrine solution (1 in 1,000) ; for instillations and injections, solutions of 0.1 Gm, (1^ grains) procaine hydrochloride in 10 or 5 cc. (160 or 80 minims) physiological solution of sodium chloride, with or without 0.6 cc. (10 minims) of epinephrine solution (1 in 1,000). In oph- thalmology, 1 to 5 or even up to 10 per cent solutions, and in rhinolaryngology 5 to 20 per cent solutions are recommended, with the addition of 0.4 to 0,5 cc. (6 to 8 minims) of epinephrine solution (1 in 1,000) to each 10 cc. (160 minims). Ampule Solution Procaine Hydrochloride 2%, 1 cc: Each cubic centi- meter contains procaine hydrochloride-U. S. P. 0.02 Gm. (J^ grain) in aqueous solution. Prepared by the Cheplin Biological Laboratories, Inc., Syracuse, N. Y. No U. S. patent or trademark. Ampule Solution Procaine Hydrochloride and Epinephrine, 3 cc: Each cubic centimeter contains procaine hydrochloride-U. S. P. 0.02 Gm. (.yi grain), epinephrine 0.04 mg. (Vieoo grain) and sodium bisulfite 0.001 Gm., in an aqueous solution containing less than 0.5 per cent of chlorobutanol. Prepared by the Cheplin Biological Laboratories, Inc., Syracuse, N. Y. No U. S, patent or trademark. 68 NEW AND NONOFFICIAL REMEDIES Procainc-Nco-Synephrin Hydrochloride Hypodermic Tablets: Each tab- let contains prcK:aine hydrochloride 0.02 Gm., neo-synephrin hydrochloride 0.0003 Gm., sodium chloride 0.007 Gm.. and potassium sulfate 0.004 Gm. One tablet dissolved in 1 cc. of distilled water yields a solution containing procaine hydrochloride 2 per cent, neo-synephrin hydrochloride 0.03 per cent, sodium chloride 0.7 per cent, and potassium sulfate 0.4 per cent. Prepared by Frederick Stearns & Co., Detroit. Ampul Solution Procaine Hydrochloride with Epinephrine, 1 cc : Each cubic centimeter contains procaine hydrochloride U. S. P. 0.02 Gm. (J4 grain), epinephrine hydrochloride 0.04 mg. (1/1,600 grain) and sodium bisulfite 0.45 mg. (1/144 grain) in aqueous solution. Prepared by the U. S. Standard Products Co., Woodworth. Wis. No U. S. patent or trademark. Novocain. — Novocain Hydrochloride. — A brand of procaine hydrochloride-U. S. P. Manufactured by Winthrop Chemical Co., Inc., New York, under U. S. patent 812,554 (Feb. 13, 1906; expired) by license of the U. S. Federal Trade Commission. U. S. trademark 53,072. Ampules Sterile Crystals Novocain for Spinal Anesthesia, 50 mg. Ampules Sterile Crystals Novocain for Spinal Anesthesia, 100 mg. Ampules Sterile Crystals Novocain for Spinal Anesthesia, 120 mg. Ampules Sterile Crystals Noz'ocain for Spinal Anesthesia, 150 mg. Ampules Sterile Crystals Novocain for Spinal Anesthesia, 200 mg. Ampules Sterile Solution Novocain 20 per cent, 1.5 cc: This solution must be diluted before it is used. Ampules Sterile Solution Novocain 20 per cent, 5 cc: This solution must be diluted before it is used. Ampules Sterile Solution Novocain 20 per cent with l-Suprarenin Synthetic Bitartrate 1:9,000, 1.5 cc: Novocain 0.3 Gm. and /-suprarenin synthetic bitartrate 0.165 mg. in distilled water to make 1.5 cc. This solution must be diluted before it is used. Ampules Sterile Solution Novocain 20 per cent with l-Suprareniii. Synthetic Bitartrate 1: 9,000, 5 cc. : Novocain 1 Gm. and /-suprarenin synthetic bitartrate, 0.55 mg., in distilled water to make 5 cc. This solution must be diluted before it is used. Ampules Novocain Solution 1 per cent, 2 cc: Novocain 0.02 Gm., sodium chloride 0.012 Gm., in distilled water to make 2 cc. Ampules Solution Novocain, 2 per cent, 3 cc: Novocain 0.06 Gm., sodium chloride 0.012 Gm., in distilled water to make 3 cc. Ampules Novocain Solution, 10 per cent, 2 cc. (For Spinal Anesthesia) : Novocain 0.2 Gm. in distilled water to make 2 cc. Ampules Novocain Solution 1 per cent with l-Suprarenin Synthetic Bitartrate 1:50,000, 2 cc. : Novocain 0.02 Gm., /-suprarenin synthetic bitartrate 0.04 mg., sodium chloride 0.009 Gm., potassium sulfate 0.008 Gm., in distilled water to make 2 cc. Ampules Novocain Solution 1 per cent with l-Suprarenin Synthetic Bitartrate 1:50,000, 6 cc: Novocain 0.06 Gm., /-suprarenin synthetic bitartrate 0.12 mg., sodium chloride 0.027 Gm., potassium sulfate 0.024 Gm. in distilled water to make 6 cc. Ampules Novocain Solution 2 per cent with l-Suprarenin Synthetic Bitartrate 1:50,000, 1 cc: Novocain 0.02 Gm., /-suprarenin synthetic bitartrate 0.02 mg., in distilled water to make 1 cc. Ampules Novocain Solution 2 per cent with l-Suprarenin Synthetic Bitartrate 1 : 20,000, 1 cc. : Novocain 0.02 Gm., /-suprarenin synthetic bitartrate 0.05 mg., in distilled water to make 1 cc. Ampules Novocain Solution 2 per cent with l-Suprarenin Synthetic Bitartrate 1:50,000, 3 cc: Novocain 0.06 Gm., /-suprarenin synthetic bitartrate 0.06 mg., sodium chloride 0.0135 Gm., potassium sulfate 0,012 Gm., in distilled water to make 3 cc, ANESTHETICS 69 Ampules Novocain Solution 2 per cent zvith l-Suprarcnin Synthetic Bitartrate 1:20,000, 3 cc: Novocain 0.06 Gm., /-suprarenin synthetic bitartrate 0.15 mg., sodium chloride 0.0135 Gm., potassium sulfate 0.012 Gm., in distilled water to make 3 cc. Ampules Novocain Solution 2 per cent with l-Suprarenin Synthetic Bitartrate 1:20,000, 6 cc: Novocain 0.12 Gm., /-suprarenin synthetic bitartrate 0.3 mg., in distilled water to make 6 cc. Ampules Ephedrine-Novocain Solution, 1 cc: Novocain 1 per cent and ephedrine hydrochloride — U. S. P. 5 per cent. Ampules Ephedrine-Novocain Solution, 2 cc: Novocain 1 per cent and ephedrine hydrochloride — U. S. P. 5 per cent. Novocain Hypodermic Tablets, 0.2 Gm.: Each tablet contains novocain 0.2 Gm. (3 grains) and sodium chloride, 0.06 Gm. (1 grain). Novocain Hypodermic Tablets, 0.05 Gm.: Novocain 0.05 Gm. (% grain). Novocain Hypodermic Tablets, 0.02 Gm. with l-Suprarenin Syncthetic Bitartrate, 0.0'2 mg.: Novocain 0.02 Gm. (J/^ grain) and I-suprarenin synthetic bitartrate 0.00002 Gm. (V^OOO grain). Novocain (0.125 Gm.) and l-Suprarenin Synthetic Bitartrate (0.125 mg.) Hypodermic Tablets: Novocain 0.125 Gm. (2 grains) and 1-supra- renin synthetic bitartrate 0.000125 Gm. (i/^oo grain). Novocain (0.1 Gm.) and l-Suprarenin Synthetic Bitartrate (0.25 mg.) Hypodermic Tablets: Novocain 0.1 Gm. (1/^ grains) and 1-suprarenin synthetic bitartrate 0.00025 Gm. (V250 grain). Novocain (0.05 Gm.)'and l-Suprarmin Synthetic Bitartrate (0.083 mg.) Hypodermic Tablets: Novocain 0.05 Gm. (% grain) and 1-supra- renin synthetic bitartrate 0.000083 Gm. (Vrso grain). Novocain (0.02 Gm.) and l-Siiprarenin Synthetic Bitartrate (0.05 mg.) Hypodermic Tablets: Novocain 0.02 Gm. (J<3 grain) and 1-suprarenin synthetic bitartrate 0.00005 Gm. (1/1200 grain). Novocain (0.06 Gm.) and l-Suprarenin Synthetic Bitartrate (0.06 mg.) Hypodermic Tablets: Each contains novocain 0.06 Gm. (1 grain), and /-suprarenin synthetic bitartrate 0.00006 Gm. (Viooo grain). Novocain Solution 1 Per Cent Ampules: Each contains novocaine, 0.06 Gm. (1 grain), sodium chloride, 0.036 Gm. (^2 grain) and distilled water, 6 cc. (90 minims). Novocain (0.08 Gm.) and l-Suprarenin Synthetic Bitartrate (0.06 mg.) Hypodermic Tablets: Novocain 0.08 Gm. and /-suprarenin synthetic bitartrate 0.06 mg. Sterile Ampules Novocain Crystals for Spinal Anesthesia, 300 mg. Sterile Ampules Novocain Crystals for Local Anesthesia, 500 mg. Tablets Novocain, 1 grain. Tablets Novocain 0.01 Gm. with l-Suprarenin Synthetic Bitartrate 0.2 mg. Procaine-Abbott. — A brand of procaine hydrochloride- U. S. P. Manufactured by the Abbott Laboratories, North Chicago. U. S. patent 812,554 (Feb. 13, 1906; expired). U. S. patent 1,260,289 (March 26, 1918; expired). Ampoules Procaane Hydrochloride Solution 10%, 2cc., For Spinal Anesthesia: Each cubic centimeter contains procaine hydrochloride, 0.1 Gm., dissolved in distilled water. Ampoules Procaine Hydrochloride Solution 2%, 5 cc: Each cubic centimeter contains procaine hydrochloride 0.02 Gm., dissolved in physio- logic solution of sodium chloride. Procaine-Epinephrine Ampules 1 cc: Procaine-Abbott 0.02 Gm. (^ grain), epinephrine 0.00004 Gm. (Vieoo grain) in Ringer's solution 1 cc. Procaine-Epinephrine Solution, 100 cc Bottle: Each cubic centimeter contains procaine hydrochloride, 2%, epinephrine 0.04 mg. (Vieoo grain), sodium bisulfite 0.001 Gm., in isotonic solution. 70 NEW AND NONOFFICIAL REMEDIES Procaine-Epinephrine Hypodermic Tablets: Each contains procaine- Abbott 0.02 Gm. (^ grain) epinephrine chloride 0.00002 Gm. (i/^5oo grain) and sufficient sodium chloride to cause the resulting solution to be approximately isotonic when the tablet is dissolved in 1 cc. of water. Procaine-Epinephrine Hypodermic Tablets: Procaine- Abbott 0.02 Gm. (Vs grain), epinephrine 0.00004 Gm. (Visoo grain) and sodium chloride sufficient so that when the tablet is dissolved in 1 cc. of water, the resulting solution is approximately isotonic. Procaine Hydrochloride Hypodermic Tablets Vs grain. Procaine Hydrochloride- Abbott Tablets, 1.14 grains (0.07 Gm.) : One tablet dissolved in 1 fluidrachm of distilled water makes a 2 per cent solution of procaine hydrochloride. Procaine Hydrochloride-Abbott Tablets, 2.28 grains (0.15 Gm.) : One tablet dissolved in 2 fluidrachms of distilled water makes a 2 per cent solution of procaine hydrochloride. Procaine Hydrochloride Hypodermic Tablets, 3 grains. Procaine Hypodermic Tablets, iyi grain. Sterile Ampojdes Procaine Hydrochloride Crystals For Spinal .4ncs thesia, 50 mg. Sterile Ampoules Procaine Hydrochloride Crystals For Spinal Anes- thesia, 100 mg. Sterile Ampoules Procaine Hydrochloride Crystals For Spinal Anes- thesia, 120 mg. Sterile Ampoules Procaine Hydrochloride Crystals For Spinal Anes- thesia, 150 mg. Sterile Ampoules Procaine Hydrochloride Crystals For Spinal Anes- thesia, 200 mg. Procaine Hydrochloride-Merck. — A brand of procaine hydrochloride-U. S. P. Manufactured by ]Merck 8c Co., Rahway. N. J. Procaine Hydrochloride-Squibb. — A brand of procaine hydrochloride-U. S. P. Manufactured by E. R. Squibb & Sons, New York. No U. S. patent or trademark. Sterile Ampules Procaine Hydrochloride-Squibb (Crystals) for Spinal Anesthesia, 50 mg. Sterile Ampules Procaine Hydrochloride-Squibb (Crystals) for Spinal Anesthesia, 100 mg. Sterile Ampules Procaine Hydrochloride-Squibb (Crystals) for Spinal Anesthesia, 120 mg. Sterile Ampules Procaine Hydrochloride-Squibb (Crystals) for Spinal Anesthesia, 150 mg. Sterile Ampules Procaine Hydrochloride-Squibb (Crystals) for Spinal Anesthesia, 200 mg. PROCAINE NITRATE.— Procainae Nitras.— GH4NH. COO.C2H4.N(C2H5)2.HN03. — l-^-aminobenzoyl-2-diethylamino- ethanol mononitrate ; /'-aminobenzoxydiethylaminoethane mono- nitrate ; /3-diethylaminoethyl-/'-amino benzoate mononitrate. Actions and Uses. — The same as those of procaine hydro- chloride. It may be prescribed in combination with silver salts, with which it forms no precipitate. Dosage. — Used in 3 per cent solutions. Procaine nitrate occurs in small colorless and odorless crystals, soluble in water and alcohol. The aqueous solution is neutral in reaction. The melting-point is from 100 to 102 C. ANESTHETICS 71 If 0.1 Gm. of procaine nitrate is dissolved in 1 cc. of concentrated sulfuric acid and a solution of ferrous sulfate carefully floated above it, a brown zone is formed at the surface of contact of the two solutions. One part of procaine nitrate dissolved in 10 parts of water and acidified with nitric acid should yield no precipitate on the addition of silver nitrate solution. It also yields the general tests described under procaine hydrochloride. TUTOCAIN. — Tutocaine Hydrochloride. — Butamin. — /'-amino-benzoyldimethylaminomethyl-butanol hydrochloride. — 7-dimethylamino-ct, /S-dimethylproply-ZJ-aminobenzoate hydro- chloride. — /)-aminobenzoyldimethylamino 1 :2 dimethyl-propanol hydrochloride.— (CH3)2N.CH2.CH(CH3)CH(CH3)(O.CO.C6H4. NH2)HC1. — The base of tutocain belongs to the procaine type, but in addition possesses two asymmetric carbon atoms ; it is optically inactive. Tutocain is therefore a racemic mixture of the hydrochlorides. Actions and Uses. — Tutocain is used by subcutaneous injec- tion, but more especially for surface anesthesia. When cor- rectly used, tutocain rapidly produces complete and prolonged anesthesia and is effective even in relatively low concentration. It is reported that complete anesthesia of the cornea occurs four minutes after the application of 0.25 to 1 per cent solu- tions in tutocain; surface anesthesia in the nose, throat and eyes is reported to develop more slowly than with cocaine, but to be equally intense. When tutocain is used by injection, the effects are very prompt. In wheal tests on human beings, a 1 per cent tutocain solu- tion produced an anesthesia that lasted for from fifteen to twenty minutes ; a 0.125 per cent solution containing epinephrine gave an anesthesia that lasted for about two hours. In experi- ments made for the Council, tutocain in 3 per cent solution was found to be about four times as toxic as procaine hydrochloride by rapid intravenous injection into the cat. A fatality has been reported following the injection of 8 cc. of a 2 per cent solu- tion into the urethra. On the other hand, experiments and clinical trials have been reported in support of the claim that tutocain is relatively safe for use in surface anesthesia and by hypodermic injection. Dosage. — For application to the eye, nose and throat, 2 to 5 per cent solutions of tutocain are used; for applications to the urethra, 0.5 to 1 per cent solutions, increased to 2 per cent in very painful procedures; for infiltration anesthesia, 0.2 per cent solutions are generally used. Tutocain solutions may be sterilized by boiling for a short time. Manufactured by Winthrop Chemical Co., Inc., New York. U S. patent 1,474,567 (Nov. 20, 1923; expires 1940). U. S. trademark 180,610. Tablets Tutocain, 0.03 Gm. with Suprarenin 0.15 mg. Tablets Tutocain, 0.03 Cm. with Suprarenin 0.06 mg. Tablets Tutocain, 0.03 Gm. Tablets Tutocain, 0.05 Gm. with Suprarenin 0.125 mg. Tablets Tutocain, 0.1 Gm. Tablets Tutocain, 0.05 Gm. 72 NEW AND NONOFFICIAL REMEDIES Tutocain occurs as a light, ivory colored crystalline powder. It is practically odorless; when applied on the tongue, it possesses a faintly bitter taste followed by a sense of numbness; it is permanent in the air. It is easily soluble in water (about 1 in 4), and difficultly soluble in alcohol (1 in 50). Its aqueous solution (1 in 10) is neutral to litmus paper. It is optically inactive. It melts at from 212 to 215 C. From aqueous solutions, alkali hydroxides and carbonates precipitate the free base as a light j^ellowish oil which solidifies after some time and melts at not less than 81 C. Dissolve about 0.1 Gm. in 5 cc. of water, add 2 drops of diluted hydrochloric acid and 2 drops of sodium nitrite solution (10 per cent) and mix with a solution of 0.2 Gm. of betanaphthol in 10 cc. of sodium hydroxide solution (10 per cent): a scarlet red precipitate is formed (distinction from phenacaine, which gives a white precipitate). Dissolve 1 Gm. in 10 cc. of water: to separate portions of 2 cc. each the solutions yield a white precipitate with 1 cc. of potassium mercuric iodide solution; a brown precipitate with 1 cc. of iodine solution; a brown precipitate with 1 cc. of gold chloride solution {distinction from apothesine, which gives a lemon yellow precipitate) ; a yellow precipi- tate with 1 cc. of picric acid solution; a white curdy precipitate with 1 cc. of nitric acid and 1 cc. of silver nitrate solution. Dissolve 0.1 Gm. in 5 cc. of water, add 2 drops diluted hydrochloric acid and 1 cc. of barium chloride solution: no precipitate forms (distinction from butyn). To a solution of about 0.1 Gm. in 5 cc. of water, add 3 drops of diluted sulfuric acid and mix with 5 drops of potassium perman- ganate solution : the violet color of the latter disappears immediately (distinction from cocaine). Dissolve about 0.1 Gm. in 1 cc. of sulfuric acid: the solution is colorless (organic impurities). Dissolve 0.1 Gm. in 10 cc. of water and saturate with hydrogen sulfide: no coloration or precipitation occurs (salts of heavy metals). Dry about 1 Gm. accurately weighed to constant weight at 100 C.: the loss does not exceed 1 per cent. Incinerate about 0.5 Gm. accu- rately weighed: there is not more than 0.2 per cent residue. Dissolve about 1 Gm. previously dried to constant weight at 100 C., weigh accurately, add a few pieces of ice and 15 cc. of hydrochloric acid and titrate with tenth-normal sodium nitrite solution using starch iodide paper as an indicator: the amount of tenth-normal sodium nitrite consumed corresponds to not less than 99 per cent nor more than 101 per cent. Anesthetics, Local, Slightly Soluble The slight solubiHty of these anesthetics renders them unsuit- able for injection, but the slow absorption renders them safer, especially for ulcers, wounds, and mucous surfaces. The anes- thesia which they induce is usually not so complete as that induced by the soluble local anesthetics ; but it is more lasting. As a group they are practically nonirritant and nontoxic. Ethyl aminobenzoate (benzocaine, anesthesin) and orthoform are about equally effective through intact mucous membranes ; butesin is claimed to be more effective than ethyl aminobenzoate. They are used for painful wounds, ulcers, etc., of the skin and accessible mucous membranes ; for instance, after dental operations. ETHYL AMINOBENZOATE. — Anesthesin. — Benzo- caine. — For standards set the U. S. Pharmacopeia under Aethylis Aminobenzoas. Actions mid Uses. — See preceding article, Anesthetics, Local, Slightly Soluble. ANESTHETICS 7?> Dosage. — Internally, from 0.3 to 0.5 Gm. (5 to 8 grains). Externally, it is applied as a dusting powder, either pure or diluted. It may be applied in ointment or in the form of suppositories. Anaesthesine. — A brand of ethyl aminobenzoate-U. S. P. Manufactured by the Winthrop Chemical Co., Inc., New York. No U. S. patent. U. S. trademark 55,744 (Anasthesin). Anesthesin-Abbott. — A brand of ethyl aminobenzoate- U. S. P. Manufactured by the Abbott Laboratories, North Chicago, 111. No U. S. patent. U. S. trademark 55,744 (Anasthesin). BUTESIN. — iz-butyl-Z'-aminobenzoate. — CcHiNHo.COO (C4H9). — ^The normal butyl ester of 4-aminobenzoic acid, C6H4NH0.COOH. Actions and Uses. — See preceding article, Anesthetics, Local, Slightly Soluble. The actions and uses of butesin are similar to those of ethyl aminobenzoate-U. S. P., but it is claimed to be more effective. Dosage. — Butesin is used as a dusting powder, either pure or diluted. It may be used in the form of troches, ointment, or suppositories or dissolved in a fatty oil. Its oil solutions may be sterilized by heat. Manufactured by the Abbott Laboratories, North Chicago, 111. U. S. patent 1,440,652 (Jan. 2, 1923; expires 1940). U. S. trademark 175,095. Butesin is a white, crystalline powder, odorless and tasteless. It is almost insoluble in water (about 1 in 7,000), soluble in dilute acids, alcohol, chloroform, ether and benzene and also soluble in fatty oils. Butesin is slowly hydrolyzed when boiled with water. It melts at from 56 to 57 C. and boils at 147 C. under 2 mm. pressure. Butesin yields colorless solutions in alcohol and ether. The addition of silver nitrate solution to its alcoholic solution acidified with nitric acid produces no precipitate. A solution of butesin in diluted hydrochloric acid is not affected by saturation with hydrogen sulfide. Add a few drops of sodium nitrite solution (1 in 10) to 2 cc. of a solution of butesin (1 in 100) in very dilute hydrochloric acid and mix with 0.2 Gm. of betanaphthol in 10 cc. of sodium hydroxide solu- tion (10 per cent): a scarlet red precipitate is given at once. To about 1 cc. of a solution of butesin (1 in 100) in very dilute hydro- chloric acid, add a few drops of iodine solution, shake the mixture and allow to stand for 10 minutes with occasional agitation: a dark brown precipitate is formed which changes into large, reddish-brown prisms (distinction from ethyl aminobenzoate which gives lustrous scales). BUTESIN PICRATE. — Dinormalbutyl-/j-aminobenzoate- trinitrophenol. (C6H4NH2.COO.C4H9)2.C6H2(N02)30H. — A compound consisting of one molecule of trinitrophenol (picric acid) and two molecules of the normal butyl ester of 4-amino- benzoic acid. Actions and Uses. — Butesin picrate combines the anesthetic action of butesin with the antiseptic properties of trinitro- phenol (picric acid). An aqueous solution of 1 in 2,000 pro- duces immediate and complete anesthesia of the eye which lasts from ten to twenty minutes. Butesin picrate is used in the treatment of burns, ulcers and other denuded painful lesions of the skin. 74 NEW AND NONOFFICIAL REMEDIES Dosage. — For use, a 1 per cent butesin picrate ointment is proposed. Manufactured by the Abbott Laboratories, North Chicago. U. S. patent 1,596,259 (Aug. 17, 1926; expires 1943). U. S. trademark 175,095. Butesin Picrate Ointment with Metaphen: Butesin picrate 1 per cent, and metaphen 1:5,000, incorporated in an ointment base composed of white wax, paraffin, petrolatum, sodium borate and water, 99 per cent. Ophthalmic Ointment Butesin Picrate 1% and Butesin 1% : Butesin picrate, 1 per cent; butesin, 1 per cent and soft petrolatum, 98 per cent. Butesin picrate is a yellow, amorphous powder; odorless; taste slightly bitter. One part of butesin picrate is soluble in 2,000 parts of water; also soluble in 100 parts of cottonseed oil; soluble in alcohol, chloroform, ether and benzene. It melts at 109 to 110 C. The aqueous solution of butesin picrate is greenish yellow; the color is intensified by the addition of alkali and is decreased by acid. A saturated, aqueous solution of butesin picrate is not affected by the addition of mercuric potassium iodide solution, of silver nitrate solution or of hydrogen sulfide solution. A few drops of sodium nitrate solu- tion added to the acidulated solution of butesin picrate followed by a few drops of a slightly alkaline solution of betanaphthol produces a salmon-colored precipitate which quickly darkens. A purplish-red color is produced if a 1 per cent potassium cyanide solution be added to an aqueous solution of butesin picrate. Incinerate 0.5 Gm. of butesin picrate, accurately weighed: the ash does not exceed 0.1 per cent. ORTHOFORM. — Orthoform-New. — Methyl m-amino-/>- oxybenzoate. — CeHa.NH^.OH.CO.O.CCHa), 3:4:1. — The m-amino-/>-oxybenzoic acid ester of methyl alcohol. Actions and Uses. — Orthoform is a local anesthetic, but penetrates the tissues very slowly on account of its insolubility. It has no action on the unbroken skin. It is practically non- toxic in the usual doses. It has been applied locally as an analgesic to wounds of every description. It has been used in dentistry and in nasal catarrh, hay fever, etc. Dosage. — Internally, from 0.5 to 1 Gm. (8 to 15 grains) in emulsion; locally, in substance as a dusting-powder or mixed with milk sugar for insufflation, dissolved in ether and mixed with oil for pencilings, or as an ointment with wool fat, etc. Manufactured by the Winthrop Chemical Co., Inc., New York. U. S. patent 610,348 (Sept. 6, 1898; expired), and 625,158 (May 16, 1899; expired). Orthoform occurs in a fine, white, crystalline powder, neutral in reaction, melting at from 141 to 143 C, odorless and tasteless. It is almost insoluble in water, freely soluble in alcohol and soluble in ether. It is decomposed, by boiling with water or by warming with alkalis or their carbonates, into methyl alcohol and paroxybenzoic acid or the alkali salt of it. When crystallized from chloroform it sometimes as- sumes the form of white crystals, melting at from 110 to 111 C. and returning on melting to the ordinary form. The filtrate obtained after shaking a small quantity of the ortho- form with water produces a transient color with ferric chloride and should not give a reaction with silver nitrate. A solution of 0.1 Gm. of orthoform dissolved in 2 cc. of water by the aid of hydrochloric acid is colored yellowish red on the addition of sodium nitrite and then deposits a yellow precipitate, deepening to red on exposure to the air. ANTIMONY COMPOUNDS 75 ANTIMONY COMPOUNDS ANTIMONY THIOGLYCOLLAMIDE.— The triamide of antimony thioglycollic acid Sb(S.CH2CO.NH2)3. It contains not less than 30 per cent of antimony. Actions and Uses. — Antimony thioglycollamide and antimony sodium thioglycollate are used in the treatment of granuloma inguinale, and are proposed for use in the treatment of lympho- pathia inguinale, kala azar and filariasis. These substances have been found to be less toxic and less irritating than antimony and potassium tartrate. The thioglycollamide has proved to be somewhat more toxic than the thioglycollate. The former is also less soluble but it has the advantage of being more stable. The drugs are used intramuscularly or intravenously. Dosage. — The usual intramuscular or intravenous dose employed by Randall is 0.08 Gm., dissolved in 20 cc. of sterile water every second day until from 15 to 25 injections have been given. He recommends that at least 12 injections be given after the first healing has taken place to insure permanent cure. Its solutions are incompatible with solutions of the fixed alkalis. Manufactured by Hynson, Westcott and Dunning, Baltimore. No U. S. patent or trademark. Ampules Solution Antimony Thioglycollamide, 0.4 per cent, 10 cc. Ampules Solution Antimony Thioglycollamide, 0.4 per cent, 20 cc. Antimony thioglycollamide is a white, crystalline, odorless powder. It is soluble in about 200 parts of water, somewhat soluble in alcohol and insoluble in ether. It melts at about 139 C. (uncorrected). Dissolve a few crystals of antimony thioglycollamide in 5 cc. of water and add a drop of ferric chloride solution; a transient blue color appears. Boil about 0.1 Gm. of antimony thioglycollamide with 5 cc. of sodium hydroxide solution: ammonia is evolved. Dissolve about 0.1 Gm. of antimony thioglycollamide in 25 cc. of warm water, add a few drops of diluted hydrochloric acid and pass in hydrogen sulfide: an orange precipitate is produced. Dissolve 0.2 Gm. of antimony thioglycollamide in 5 cc. of hydro- chloric acid, add 10 cc. of freshly prepared stannous chloride solution and allow to stand 30 minutes: no brownish tint or precipitate is visible if viewed from above over a white surface (arsenic). A blank test should be carried out, using the same quantities of reagents. Weigh accurately from 0.2 to 0.3 Gm. of antimony thioglycollamide, dissolve it in about 100 cc. of warm water, add 1 cc. of diluted hydro- chloric acid, pass in hydrogen sulfide until precipitation is complete and allow to stand 30 minutes. Collect the antimony sulfide in a weighed Gooch crucible, wash it successively with water containing hydrogen sulfide, alcohol, ether, carbon disulfide, alcohol and ether, dry the residue at 110 C. and weigh. The antimony sulfide obtained corresponds to not less than 30 per cent of antimony. ANTIMONY SODIUM THIOGLYCOLLATE.— The compound formed by dissolving antimony trioxide in a solution of a mixture of sodium thioglycollate and thioglycollic acid. / S.CH.CGONa St,/ It contains not less than Z/ per cent I \ S.CH2COO , of antimony. Id NEW AND NONOFFICIAL REMEDIES Actions and Uses. — The same as for antimony thioglycolla- mide. It is more soluble than antimony thioglycollamide, and in higher dosages it appears to be less toxic. Dosage. — From 0.05 to 0.1 Gm. (1 to 2 grains) dissolved in 10 to 20 cc. of sterile water every third or fourth day until from 15 to 25 injections have been given. Its solutions are incompatible with solutions of the fixed alkalis. Manufactured by Hynson, Westcott and Dunning, Baltimore. No U. S. patent or trademark. Ampules Solution Antimony Sodium Thiogly collate, 0.5 per cent, 10 cc. Ampules Solution Antimony Sodium Thioglycollate, 0.5 per cent, 20 cc. Antimony sodium thioglycollate is a white or faintly pinkish powder; odorless or having a faint odor of mercaptan; very soluble in water; insoluble in alcohol. Add a drop of diluted hydrochloric acid to 3 cc. of a dilute solution of antimony sodium thioglycollate (1 in 100) and add two drops of 1 per cent ferric chloride solution: a transient blue color results. Add a drop of 1 per cent ammonia water to this mixture and shake: a Burgundy red color results. Add a few drops of sodium hydroxide solution to a dilute solution of antimony sodium thioglycollate (1 in 100): a white precipitate is produced. Dissolve about 0.1 Gm. of antimony sodium thioglycollate in 2 cc. of water, add a few drops of diluted hydrochloric acid and pass in hydrogen sulfide: an orange-colored precipitate is produced. Weigh accurately from 0.2 to 0.3 Gm. of antimony sodium thiogly- collate, dissolve it in about 100 cc. of warm water, add 1 cc. of diluted hydrochloric acid, pass in hydrogen sulfide until precipitation is com- plete and allow to stand 30 minutes. Collect the antimony sulfide^ in a weighed Gooch crucible, wash it successively with water containing hydrogen sulfide, alcohol, ether, carbon disulfide, alcohol and ether, dry the residue at 110 C. and weigh. The antimony sulfide corres- ponds to not less than 2,7 per cent of antimony. ARBUTIN.— Arbutinum.— CioHkOt.+^H^O.-— Aglucoside occurring in the leaves of Arctostaphylos uva-ursi, Vaccinium vitis-idaea and many other genera of the family Ericaceae. Actions 'and Uses. — Arbutin probably owes its effect, at least in part, to the antiseptic action of hydroquinone, formed by its decomposition in the urinary tract. It has been used as a urinary antiseptic and diuretic. Dosage. — From 0.2 to 0.5 Gm. (3 to 8 grains) three or four times a day. Arbutin occurs in long, glistening, colorless needles, or as a fine, white crystalline, odorless powder having a bitter taste. It is solu- ble in 8 parts of water and 16 parts of alcohol; very soluble in hot water and hot alcohol; insoluble in chloroform, ether and carbon disulfide. _ Its aqueous solution is neutral to litmus paper and is not precipitated by solutions of the metallic salts or by solutions of tannin. Its aqueous solution is colored blue by ferric chloride test solution. By boiling with diluted sulfuric acid or by treatment with emulsion, arbutin is converted into glucose and hydroquinone. When heated to 100 C. arbutin loses its water of hydration. At 195 C. the anhydrous glucoside melts. It should leave no residue on ignition. An aqueous solution of arbutin (1 in 20) should not be affected by hydrogen sulfide (lead). ARSENIC COMPOUNDS 11 Arbutin-Abbott. — A brand of arbutin-N. N. R. Manufactured by the Abbott Laboratories, North Chicago, 111. No U. S. patent or trademark, Arbutin-Merck. — A brand of arbutin-N, N, R. Merck & Co., Inc., Rahway, N, J., distributor. No U. S. patent or trademark. ARSENIC COMPOUNDS In some of the compounds listed in this chapter, the arsenic is pentavalent; in others it is trivalent. A typical arsenic reaction results only from the trivalent arsenic, and in order to secure this action from those compounds containing penta- valent arsenic, their arsenic must be reduced to the trivalent form ; this is done by the body, but the rate at which the reduction occurs varies greatly with the different compounds. In some cases, the desirable, as well as the undesirable, effects produced by these compounds are due to the arsenic which is slowly rendered active ; in others the therapeutic effects may be due, at least in part, to the unaltered molecules. The dis- eases in which arsenic therapy has proved useful are particu- larly those caused by protozoa. Inorganic arsenic will kill protozoa, but it cannot be administered so as to reach the protozoa in fatal quantity. In the body, the organic compounds are less toxic to mammals and more toxic to protozoan para- sites. In this way they become available for combating trypano- somiasis, treponematosis, spirillosis and other protozoan infec- tions. Among the advantages claimed for, or known to be possessed by, these compounds, the following may be mentioned: In those known to produce their effects through the liberation of arsenic, the arsenic is liberated slowly ; some remain in the circulating blood for a much longer period than do inorganic arsenic compounds and thus remain longer in contact with parasites which it is desired to kill; some are specifically etio- tropic, that is, they have a much greater affinity for the para- sites causing the disease than they have for the tissues of the host. Arsphenamine and analogous preparations of arsenic used intravenously come under the federal law covering serums, viruses, toxins and analogous products, and are subject to the same control. COMPOUNDS CONTAINING TRIVALENT ARSENIC According to Ehrlich's view, only trivalent arsenic is markedly toxic to spirochetes, trypanosomes, etc, ; hence he introduced a number of such compounds. Of these only the compounds in which the toxicity is reduced or modified by the introduction into the molecules of certain groups, are listed 78 NEW AND NONOFFICIAL REMEDIES below. These compounds have, according to Ehrlich, a special affinity for certain organisms, particularly spirochetes, while their toxicity for the higher animals is comparatively low. The exact fields of usefulness of these compounds and their limita- tions, and also the best methods of administering them, are still under discussion. The toxic actions of arsphenamine are ascribed to the arsenic component in some cases. In other cases the decomposition of the solution has been assigned as a cause. Undoubtedly some reactions are due to idiosyncrasies on the part of the patient. However, there is seen a large group of these cases which must be explained otherwise. Certainly, improper technique in the preparation of the drug, as well as the improper (for example, too rapid) administration may add to the inherent toxicity. The administrator should always observe the direc- tions supplied by the manufacturers to the letter. If this be done and there are still reactions, then only can we look else- where for the causation. The water used should be, if possible, freshly distilled and freshly sterilized. All chemicals should be pure. Any rubber tubing employed for the first time should be soaked over night in 5 per cent sodium hydroxide solution, then boiled in distilled water and thoroughly washed with the same. Some reactions are undoubtedly due to administration of the drug to a patient on a full stomach or to one not properly prepared by previous catharsis. It is always well to start the use of arsenical with a small dose — because of possible idiosyncrasies. One should not be too much alarmed in a fresh case of syphilis by the reaction seen after the first injection of the arsphenamines — the Herxheimer reaction. It is that phenome- non of the reaction of the disease to the arsphenamine in which there is a rise of temperature, headache, possible nausea, malaise, and marked accentuation of the cutaneous and mucous mem- brane symptoms. One should be concerned, however, if with succeeding injections there are promptly recurring reactions in the form of gastritis, itching of the skin, urticaria, fixed areas of dermatitis that flare up with each new injection, more or less generalized dermatitis or jaundice. In addition, there are sometimes noted generalized exfoliative dermatitis, purpura hemorrhagica, aplastic anemias, acute yellow atrophy and encephalitis. The best treatment of these conditions is prophylaxis, and these drugs should never be readministered without inquiry of the patient and examination of the skin as to possible pruritus, jaundice, cutaneous eruptions, or other symptoms. Moreover, a urine examination should always be a preliminary. Sodium thiosulfate has been employed to combat these manifestations. While its greatest usefulness appears to be in its early employ- ment in the case of jaundice and exfoliative dermatitis, it may also have a definite value in clearing up other early reactions. ARSENIC COMPOUNDS 79 Evidence of its value in combating purpura hemorrhagica and encephaHtis is not so clear, but it is sufficient to indicate its trial. Arsphenamines are contraindicated or should be used with special caution in diseases of the eye of a nonsyphilitic char- acter, in severe affections of the heart and blood vessels, the lungs and the kidneys and in advanced degenerative processes in the central nervous system. They should also be used with caution in infants. Arsphenamine should not be used in begin- ning luetic optic neuritis until after some preliminary antiluetic therapy with either bismuth or mercury salts. COMPOUNDS CONTAINING PENTAVALENT ARSENIC CH3 CfiN4Nno O = As— CH3 O = As— OH \ \ ONa ONa Sodium cacodylate Sodium arsanilate C6H4NHCH2CONH2 O = As— OH ONa . Tryparsamide In one of the compounds listed above, the arsenic is iti com- bination with an alkyl group and is thus analogous to the cacodylates ; in the others the arsenic is in combination with aniline, and is thus analogous to arsanilic acid. Arsanilic acid is derived from arsenic acid, AsO.(OH)3 by replacing one hydroxyl by aniline (phenylamine) CeHsNHs; related compounds are made by substituting derivatives of aniline. The compounds containing pentavalent arsenic are compara- tively nontoxic when introduced into the animal system until changes take place that liberate the arsenic. When they are slowly decomposed, they produce favorable effects. If the reduction takes place with greater rapidity, they may produce ordinary arsenic poisoning. Sodium cacodylate is excreted partly unchanged and partly as cacodylic oxide, which gives a foul odor to the breath, per- spiration, etc. Further changes yield products containing inor- ' ganic, trivalent arsenic, by which the therapeutic effects are produced. Sodium arsanilate has been used chiefly against trypanosomes. This salt has no direct action on these parasites, but owes its effects to the products resulting from its reduction in the sys- tem. These products appear to be organic compounds contain- ing the arsenic in the trivalent form. Artificial reduction products, which vary according to conditions, are much more active than the arsanilate. 80 NEW AND NONOFFICIAL REMEDIES Sodium arsanilate has also been recommended for the con- ditions which are influenced favorably by other forms of arsenic, but this salt seems to have no advantages over the official preparations of arsenic. In poisonous doses or when excessive reduction occurs, sodium arsanilate may produce the ordinary toxic effects of arsenic. It acts with especial violence on the optic nerve, producing optic atrophy, frequently resulting in permanent blindness. This may occur unfortunately even with therapeutic doses. Tryparsamide is a powerful trypanocide and only slightly treponemacidal. The drug, according to studies of Voegtlin and co-workers, when injected intravenously results in pro- nounced penetration of the nervous system tissue. This may explain its great value in the treatment of resistant syphilis of the central nervous system. It seems to be particularly valuable following malaria therapy. The suggestion has been made by Young and Loevenhart that the effect on the optic nerve fre- quently seen after tryparsamide is due to the presence of the amino group in the para position to the arsenic (Stokes). Because of this fact the physician should exercise great caution in the use of this drug. Compounds Containing Trivalent Arsenic ARSPHENAMINE. — Diaminodihydroxyarsenobenzene Hydrochloride. — "Arsphenamine or 3,3' diamino 4,4' dihydroxy- arsenobenzene dihydrochloride, contains not less than 30 per cent of arsenic (As), and complies with the requirements of the National Institute of Health, United States Public Health Service."-?7. 6^. P. For standards see the U. S. Pharmacopeia under Arsphen- amina. Actions and Uses. — Arsphenamine is useful as a specific remedy for syphilis in all stages. According to available data, in incipient tabes, early paralysis, epilepsy and cerebrospinal syphilis the drug can be employed with the prospect of most benefit in those cases in which its use is begun early. The drug is used in the spirillum affections, such as relapsing fever and frambesia ; it is also said to be an available substitute for arsenic in the treatment of diseases of the skin and nerves and in the anemias. The remedy is contraindicated in severe disturbances of the circulatory organs, advanced degenerations of the central ner- vous system and cachexias, unless these are a direct result of syphilis ; it is also contraindicated in patients who have pro- nounced idiosyncrasy against arsenic. _ It has been employed successfully in various types of syphi- litic diseases of the eyes. As a rule in such cases it is well to give a preliminary course of mercury or bismuth injections ARSENIC COMPOUNDS 81 in order to obviate the danger of a Herxheimer reaction. Repeated injections should be given. It may be used up to 0.01 Gm. per kilogram of body weight, but it is better to keep under this dose. Dosage. — Usually from 0.2 to 0.4 Gm. (3 to 6 grains) ; though 0.6 Gm. (9 grains) may be given, the smaller doses are more extensively used. For children from 0.1 to 0.2 (1^ to 3 grains). In infants doses of from 0.02 to 0.1 Gm. (^^ to 1^ grains) may be used. The dose should be varied according to the strength and con- dition of the patient. The intravenous method is preferable and is to be recommended. For intravenous injection one should proceed thus: The ampule containing the drug is immersed in alcohol, in order to be sure that a cracked tube is not being used ; then the tube is carefully wiped off, the neck filed across and broken ofif, and the contents sprinkled on sterile distilled water (10 cc. for each 0.1 gram of the drug used), contained in a sterile Erlen- meyer flask. The drug is allowed to dissolve with little or no agitation. Normal sodium hydroxide is then added to the solu- tion, using 0.85 cc. to every 0.1 Gm. of the drug. Thus 0.6 Gm. of the drug would require 5.1 cc. of normal alkali. A precipitate of the base is first formed, which, after the contents are care- fully agitated, is again brought into solution, the fluid being strongly alkaline. Filter the alkalinized solution through sterile gauze, 4 ply, and dilute the filtrate with sterile distilled water to make 25 cc. for each 0.1 Gm. of the drug. It should stand 30 minutes before using. At least one minute should be allowed for each 25 cc. of the solution to flow into the vein, using the gravity method. The directions accompanying the drug as to temperature of the water, etc., should be followed. The con- tents of a tube should be used at once after opening, and under no circumstances should the contents of a tube damaged in transportation or any remnants of the powder from previously opened tubes be used. In all cases the skin should be disinfected with tincture of iodine or with alcohol. In the treatment of syphilis of the central nervous system, the Swift-Ellis method of intraspinal treatment is utilized at times. This is a very delicate procedure, and should be employed only by physicians proficient in its use. Arsphenamine-D. R. L.— A brand of arsphenamine-U. S. P. Manufactured by Abbott Laboratories, North Chicago, 111. Arsphenamine-AIallinckrodt. — A brand of arsphenamine- U. S. P. Manufactured by Mallinckrodt Chemical Works, St. Louis. Arsphenamine-Searle. — A brand of arsphenamine-U. S. P. Prepared by G. D. Searle & Co., Inc., Chicago. Arsphenamine-Squibb. — A brand of arsphenamine-U. S. P. Manufactured by E. R. Squibb & Sons, New York. J 82 NEW AND NONOFFICIAL REMEDIES Arsphenamine-Merck. — A brand of arsphenamine-U. S. P. Manufactured by Merck & Co. Inc., Rahway, N. J. Arsphenamine-Merck, 0.1 Gni. Ampules. Arsphenamine-Merck, 0.2 Gm. Ampules. Arsphenamine-Merck, 0.3 Cm. Ampules. Arsphenamine-Merck, 0.4 Gm. Ampules. Arsphenamine-Merck, 0.5 Gm. Ampules. Arsphenamine-Merck, 0.6 Gm. Ampules. Diarsenol. — A brand of arsphenamine-U. S. P. Manufactured by the Diarsenol Company, Inc., Buffalo, N. Y. Diarsenol, 0.1 Gm. Ampoules. Diarsenol, 0.2 Gm. Anjpotilcs. Diarsenol, 0.3 Gm. Ampoules. Diarsenol, 0.4 Gm. Ampoules. Diarsenol, 0.5 Gm. Ampoules. Diarsenol, 0.6 Gm. Ampoules. Diarsenol, 1.0 Gm. Ampoules. Diarsenol, 2.0 Gm. Ampoules. Diarsenol, 3.0 Gm. Ampoules. Salvarsan. — A brand of arsphenamine-U. S. P. Manufactured by Winthrop Chemical Co., Inc., New York. U. S. trademark 40,734. Salvarsan, 0.1 Gm. Tubes. Salvarsan, 0.2 Gm.. Tubes. Salvarsan, 0.3 Gm. Tubes. Salvarsan, 0.4 Gm. Tubes. Salvarsan, 0.5 Gm. Tubes. Salvarsan, 0.6 Gm. Tubes. Salvarsan, 1 Gm. T..bes. Salvarsan, 1.2 Gm. Tubes. Salvarsan, 2 Gm. Tubes. Salvarsan, 3 Gm. Tubes. BISMARSEN. — Sulfarsphenamine Bismuth. — Bismuth Arsphenamine Sulfonate. — The sodium salt of a bismuth deriva- tive of arsphenamine methylene sulfonic acid (the exact struc- tural formula of which has not been established) with inorganic salts. It contains approximately 13 per cent of arsenic and 24 per cent of bismuth. Actions and Uses. — For the treatment of syphilis. The drug is said to be somewhat slower in its action than intramuscu- larly administered sulfarsphenamine or intravenously admin- istered neoarsphenamine. More or less severe pains at the site of injection have been reported. Dosage. — Bismarsen is administered intramuscularly. The initial dose is 0.1 Gm. ; for succeeding doses 0.2 Gm. of the drug dissolved in an ampule with 1 cc. of sterile distilled water at the time of administration, adding to the solution 2 to 3 drops of a 2 per cent solution of butyn. Weekly doses may be later increased to biweekly doses in courses of treatment of twenty doses, or more. Manufactured by the Abbott Laboratories, North Chicago, 111. U. S. patent 1,605,691 (Nov. 2, 1926; expires 1943). U. S. trademark 230,625. ARSENIC COMPOUNDS 83 Bismarsen is prepared by adding a solution of potassium bismuth tartrate in water to an aqueous solution of 3,3' diamino 4,4' dihydrox- arsenobenzene N,N' dimethylene sulfonate, dissolving the precipitate with a measured quantity of sodium hydroxide solution, precipitating by pouring the clear solutiofl into a methyl alcohol-ether mixture and filtering off the precipitate and drying it in vacuo. Bismarsen is a brownish-yellow amorphous powder readily soluble in water, yielding a yellow solution which is slightly alkaline to litmus. Add 2 cc. of diluted hydrochloric acid to 5 cc. of a 1 per cent solu- tion of bismarsen: a white opalescence appears and dissolves almost immediately; a heavy white gelatinous precipitate develops in two min- utes. Add 1 cc. of diluted nitric acid to 5 cc. of a 1 per cent solution of bismarsen: the solution gradually turns brown and yields a precipi- tate. Add 1 cc. of trinitrophenol solution to 5 cc. of a 1 per cent solution of bismarsen: no apparent reaction takes place (distinction from silver arsphenamine and potassium bismuth tai-trate). Bubble hydrogen sulfide through a 1 per cent solution of bismarsen: the solution darkens immediately but no precipitate is formed. Add 5 cc. of hydrogen peroxide solution to 5 cc. of a 1 per cent solution of bismarsen: the solution is at first turbid, then becomes a deep reddish brown with formation of a precipitate. Add 1 cc. of mercuric potassium iodide solution to 5 cc. of a 1 per cent solution of bismarsen: the solution yields a greenish-yellow opalescence, which in turn assumes a dirty green color on standing. Add drop by drop 2 cc. of a 40 per cent sodium hydroxide solution to 5 cc. of a 1 per cent solution of bis- marsen: the solution gradually darkens without any formation of pre- cipitate. Add 0.5 cc. of a 2 per cent silver nitrate solution to 5 cc. of a 1 per cent solution of bismarsen: a dark red solution is produced (distinction from arsphenamine). Add 1 cc. of a saturated solution of bromine in water to 5 cc. of a 1 per cent solution of bismarsen: The solution yields a greenish-brown precipitate (distinction from siilf- arsphenamine, neoarsphenamine and arsphenamine). Add. 0.5_ Gm. of zinc dust and 5 cc. of diluted hydrochloric acid to 0.1 Gm. of bismarsen in a test tube and at the mouth of the tube hold a strip of filter paper moistened with 5 per cent cadmium chloride solution: the paper turns yellow in four minutes. Transfer about 0.4 Gm. of bismarsen, accurately weighed, to a Kjeldahl flask, add 2 cc. of sulfuric acid and heat carefully; add 2 cc. of nitric acid a drop at a time, continue heating until brown fumes cease to be given off. cool and add water to make 120 cc; if a white crystalline precipitate appears, dissolve it with a few drops of hydro- chloric acid; transfer to a 250 cc. beaker, add 7 Gm. of tartaric acid, neutralize with strong ammonia water and add 10 cc. of magnesia mix- ture followed by 20 cc. stronger ammonia water, allow to stand twelve hours, filter through a hard surface filter paper and wash the precipitate with 50 cc. of 2.5 per cent ammonia water, puncture the filter, transfer the precipitate into a 250 cc. beaker with washings, then add just sufficient hydrochloric acid to dissolve the precipitate, filter, wash the filter well with water, neutralize the filtrate with stronger ammonia water; add 1 cc. of magnesia mixture and 20 cc. of stronger ammonia water; allow to stand twelve hours; filter, using a prepared Gooch crucible; wash with 2.5 per cent ammonia water; dry at 100 C. ; ignite at 700 C. for three hours; cool in a desiccator and weigh as magnesium pyroarsenate and calculate to arsenic: the arsenic content is not less than 12.50 per cent nor more than 13.50 per cent. Transfer about 0.25 Gm. of bismarsen accurately weighed to an Erlenmeyer flask. Add 5 cc. of diluted sulfuric acid followed by 1 Gm. of powdered potassium permanganate, and 10 cc. of sulfuric acid in small portions; add just sufficient hydrogen peroxide to dissolve the brown precipitate; add 50 cc. of water; boil for twenty minutes; cool to 70 C.; saturate with hydrogen sulfide for twelve hours; filter, using a prepared Gooch crucible; wash the precipitate with water, warm ammonium polysulfide, methyl alcohol, carbon bisulfide and acetone in the order named; dry at 100 C.; cool in a desiccator and weigh as bismuth sulfide (Bi2S3) ; calculate to bismuth: the percentage of bismuth found corresponds with the percentage of arsenic found multiplied by 1.86 (factor As to Bi in C2iH2iOi2As3Na3S3N3Bi2) plus or minus 0.5 per cent. 84 NEW AND NONOFFICIAL REMEDIES MAPHARSEN.— The hemialcoholate of 3-ammo-4-hydroxy phenylarsine oxide hydrochloride.— HC1.(NH0 C6H3(OH)AsO. ^C2H50H. It contains approximately 29 per cent of trivalent arsenic. Actions and Uses. — Mapharsen is proposed for the treatment of syphilis. It is stated to exhibit a relatively constant para- siticidal value. It is claimed to have a rapidly beneficial effect, particularly on early syphilis, with disappearance of spirochetes, healing of lesions, and reversal of positive Wassermann reac- tions in a large percentage of cases. The reactions following the use of mapharsen have on the whole been less severe than those observed after the use of arsphenamine or neoarsphen- amine. Dosage. — Intravenously, 0.03 Gm. for women and 0.04 Gm. for men, initially. The dose may be increased at the second injection to 0.04 Gm. for women and 0.06 Gm, for men. The maximum weekly dose, which should not be given any patient at the first injection, may be regarded as 0.06 Gm. For chil- dren, the initial dose should not exceed 0.0005 Gm. (0.5 mg.) per kilogram of body weight; the total weekly dose should average between 0.0005 and 0.001 Gm. (between 0.5 and 1 mg.) per kilogram of body weight. It should be noted that the dosage of mapharsen is much lower than that of the arsphenamines. Manufactured by Parke, Davis & Co., Detroit. U. S. Patent applied for. U. S. trademark 299,173. Ampoules Mapharsen 0.04 Gm.: Each ampule contains mapharsen 0.04 Gm., anhydrous sodium carbonate 0.008 Gm. and anhydrous purified sucrose 0.152 Gm. Ampoules Mapharsen 0.06 Gm.: Each ampule contains mapharsen 0.06 Gm., anhydrous sodium carbonate 0.012 Gm. and anhydrous puri- fied sucrose 0.228 Gm. Ampoules Mapharsen 0.4 Gm. : Each ampule contains mapharsen 0.4 Gm., anhydrous sodium carbonate 0.08 Gm. and anhydrous purified sucrose 1.52 Gm. Caution: This ampule is a hospital package and represents ten doses of 0.04 Gm. each. Ampoules Mapharsen 0.6 Gm.: Each ampule contains mapharsen 0.6 Gm., anhydrous sodium carbonate 0.12 Gm. and anhydrous purified sucrose 2.28 Gm. Caution: This ampule is a hospital package and represents ten doses of 0.06 Gm. each. Mapharsen occurs as a white amorphous, odorless powder. It is soluble in water, alcohols, acids, alkalis and alkali carbonates. The aqueous solution is acid to methyl red but alkaline to congo red. Add 0.5 Gm. of sodium hydrosulfite to about 0.1 Gm. of mapharsen dissolved in 10 cc. of water; a yellow precipitate separates. Add sodium carbonate solution drop by drop to a 1 per cent aqueous solution of mapharsen: no precipitate is formed (distinction from arsphenamine). Add diluted hydrochloric acid to a 1 per cent aqueous solution of mapharsen: no precipitate is formed (distinction from neoarsphenamine). Add 2 cc. of colorless 20 per cent hydriodic acid to about 0.02 Gm. of mapharsen: a color not deeper than a lemon yellow is produced (3 ammo 4 hydroxy phenyl ar sonic acid). Transfer about 0.15 Gm. of mapharsen accurately weighed to a wide mouth weighing bottle and dry to constant weight in a vacuum desic- cator over phosphorus pentoxide: the sample loses not more than 2 per cent. ARSENIC COMPOUNDS 85 Dissolve about 0.1 Gm. of mapharsen accurately weighed in 25 cc. of distilled water, titrate with tenth normal iodine solution using a starch indicator: the trivalent arsenic is not less than 28.2 per cent nor more than 29.5 per cent. Dissolve about 0.2 Gm. of mapharsen accurately weighed in 5 cc. of sulfuric acid in a 250 cc. Erlenmeyer flask, add 1 cc. of nitric acid, heat on the hot plate for an hour, add 1 cc. of nitric acid, heat on the hot plate until the solution is clear and colorless; cool, add 10 cc. of water, heat on the hot plate until white fumes appear; cool, transfer to a 600 cc. beaker, dilute to about 100 cc, make the solution alkaline to litmus paper by adding stronger ammonia water, add stronger ammonia to the amount of one third of the volume, add 20 cc. of ammonium chloride and 25 cc. of magnesia mixture. Allow to stand over night, collect the precipitate in a tared Gooch crucible, wash the precipitate with dilute ammonia water (1 volume of stronger ammonia water with 2 volumes of water) dry at 100 C., heat in a muffle furnace at 400 C. for four hours, then gradually raise the temperature to 800 C.; cool in a desiccator and weigh: the arsenic calculated on the dry basis is less than 30 per cent. Dissolve about 0.1 Gm. of mapharsen accurately weighed in about 25 cc. of distilled water; titrate to the green color of bromthymol blue with tenth-normal sodium hydroxide solution: the hydrogen chloride calculated on the dry basis is not less than 14.0 per cent nor more than 14.7 per cent. NEOARSPHENAMINE.— "Consists chiefly of sodium 3,3'- diamino-4,4'-dihydroxyarsenobenzene methanal sulfoxylate. It contains not less than 19 per cent and not more than 22 per cent of As and complies with the requirements of the National Institute of Health, United States Public Health Service. "- U. S. P. For standards see the U. S. Pharmacopeia under Neoars- phenamina. Actions and Uses. — Neoarsphenamine is a modified soluble compound of arsphenamine ; its actions and uses are those of arsphenamine. Dosage. — Neoarsphenamine is probably less toxic than ars- phenamine and, since it contains less arsenic, it is given in larger doses than arsphenamine. The average dose for a man is 0.45 to 0.60 Gm. (7 to 10 grains), with 0.45 Gm. (7 grains) as the minimum and possibly 0.75 Gm. (12 grains) for very large men. For women, 0.45 Gm. (7 grains) is the average if the patient is about the normal in weight; 0.3 Gm. (5.0 grains) would be the minimum, and 0.6 Gm. (10 grains) the maximum, the latter dose being given only to large women. Children may be given 0.1 to 0.2 Gm. (1.5 to 3 grains). The limit dose is 15 mg. (% grain) per kilogram of body weight. Here again a smaller dose is preferable. Neoarsphenamine may be administered by intravenous or intramuscular injection, the former being considered decidedly preferable; the drug must not be administered subcutaneously. In babies with congenital syphilis, some physicians administer it under the fascia of the scalp. For intravenous injection, 12.5 cc. of freshly distilled water should be used for each 0.1 Gm. of neoarsphenamine. For the intramuscular or subfascial 86 NEW AND NONOFFICIAL REMEDIES injections, 3 cc. of freshly distilled water should be used for each 0.15 Gm. of neoarsphenamine, this yielding an approxi- mately isotonic solution. Neoarsphenamine may be employed intravenously in concen- trated solutions. For this purpose as much as 0.1 Gm. may be dissolved in 0.5 cc. of sterile freshly distilled water; the injec- tion is made with a syringe instead of by gravity. It is well to draw out an equal amount of blood into the syringe con- taining the neoarsphenamine solution before reinjecting into the blood stream. It should be injected very slowly. The ampule containing the drug is immersed in alcohol to detect a possible crack, then carefully wiped off; the neck filed across and broken off, and the contents sprinkled on the surface of cool, sterile distilled water and allowed to dissolve without shaking the solution. Any product incompletely soluble should be discarded. Solutions of neoarsphenamine must be injected immediately after their preparation. Neoarsphenamine must not be warmed and the temperature of the injected fluid should not be more than 20 to 22 C. (68 to 71.6 F.). Neoarsphenamine may undergo deterioration in the ampule, and care should be exercised to use a drug of normal color and free solubility. The drug in fresh solution should be of canary yellow color. This drug should preferably be kept in a cool dark room or ice box and be not more than 6 months old. Neoarsphenamine-D. R. L. — A brand of neoarsphenamine- U. S. P. Manufactured by Abbott Laboratories, North Chicago, 111. Neoarsphenamine-Mallinckrodt. — A brand of neoarsphen- amine-U. S. P. Manufactured by Mallinckrodt Chemical Works, St. Louis. Neoarsphenamine-Merck. — A brand of neoarsphenamine- U. S. P. Manufactured by Merck & Co., Inc., Rahway, N. J. Neoarsphenamine-Merck, 0.15 Gm. Ampules. Neoarsphenamine-Merck, 0.3 Gm. Ampules. Neoarsphenamine-Merck, 0.45 Gm. Ampules. Neoarsphenamine-Merck, 0.6 Gm. Ampules. Neoarsphenamine-Merck, 0.75 Gm. Ampules. Neoarsphenamine-Merck, 0.9 Gm. Ampules. Neoarsphenamine-Searle. — A brand of neoarsphenamine- U. S. P. Prepared by G. D. Searle & Co., Inc., Chicago. Neoarsphenamine-Squibb. — A brand of neoarsphenamine- U. S. P Manufactured by E. R. Squibb & Sons, New York. ARSENIC COMPOUNDS 87 Neodiarsenol. — A brand of neoarsphenamine-U. S. P. Manufactured by the Diarsenol Company, Inc., Buffalo, N. Y. Neodiarsenol, 0.15 Gm. Ampoules. Neodiarsenol, 0..^ Gtn. Ampoules. Neodiarsenol, 0.45 Gm. Ampoules. Neodiarsenol. 0.6 Gm. Ampoules. Neodiarsenol, 0.75 Gm. Ampoules. Neodiarsenol. 0.9 Gm. Ampoules. Neodiarsenol, 1.5 Gm. Ampoules. Neodiarsenol, 1.8 Gm. Ampoules. Neodiarsenol, 3 Gm. Ampoules. Neodiarsenol, 4.5 Gm. Ampoules. Neosalvarsan. — A brand of ncoarsphenamine-U. S. P. Manufactured by Winthrop Chemical Co., Inc., New York. U. S. trademark 88,862. Neosalvarsan, 0.15 Gm. Ampules. Neosah'arsan, 0.3 Gm. Ampules. Neosalvarsan, 0.45 Gm. Ampules. Neosah'arsan, 0.6 Gm. Atnpules. Neosalvarsan, 0.75 Gm. Ampules. Neosalvarsan, 0.9 Gm. Ampules. Neosalvarsan, 1.5 Gm. Ampules. Neosalvarsan. 1.8 Gm. Ampules. Neosalvarsan, 3.0 Gm. Ampules. Neosalvarsan, 4.5 Gm. Ampules. SILVER ARSPHENAMINE. — Argentum Arsphen- amina. — Sodium Silver Arspbenamine. — The sodium salt of silver-diamino-dihydroxy-arseno-benzene (the exact molecular formula has not been established). Silver arspbenamine con- tains not less than 19 per cent of arsenic and from 12 to 14 per cent of silver. Actions and Uses. — Silver arspbenamine has practically the same uses as those of arspbenamine. Its claimed advantage over other arspbenamine preparations is said to be due to the introduction of the silver (nonionizable form) as a component, thereby improving the chemo-therapeutic index, presumably because of the fact that silver and its compounds have a decided antisyphilitic influence. In the presence of organic diseases of the heart, such as aneurysm and aortitis, as well as in other parenchymatous dis- eased conditions of the glandular structures (liver and kidney), silver arspbenamine should be used only with great caution and in small doses, the patient and all functions being observed most carefully. Untoward symptoms noted after the use of arspbenamine and of neoarsphenamine have likewise been seen after the use of silver arspbenamine. Argyria may occur rarely as a sequel to the use of this preparation. Dosage. — From 0.1 Gm. to 0.3 Gm. for adults. The treat- ment should begin with an injection of 0.1 Gm., gradually increasing the dosage, at intervals of not less than four days, to 0.2 Gm. maximum in women and 0.3 Gm. in men. The larger doses are indicated only if the preparation is well toler- ated by the patient. The doses of 0.2 to 0.25 Gm. may be given 88 NEW AND NONOFFICIAL REMEDIES at regular intervals of 7 days and repeated until the desired therapeutic results have been achieved. Patients with disorders of the nervous S3^stem or those suffering from severe headaches should be given smaller initial doses, 0.05 and 0.075 Gm. When these amounts are well tolerated, larger doses may be employed, increasing very gradually. In preparing the solution for injection, the ampule is first sterilized and tested for cracks, by immersion in alcohol for 15 minutes ; after opening the ampule, the contents are sprinkled on the surface of 5 cc. of cool (20-22 C), sterile, distilled water, contained in a small sterile flask. The silver arsphen- amine will go into solution rapidly ; heating and shaking must be avoided. A quantity of cool sterile solution of sodium chloride, 0.4 per cent, is then added so that the final solution will approximate 20 cc. of liquid per decigram (0.1 Gm.) of the drug. The solution must he administered promptly. Silver arsphenamine is prepared by treating the dihydrochloride of 3-diamino-4-dihydroxy-l-arsenobenzene (arsphenamine) with silver salts, converting the resulting compound to the disodium salt and precipitating ijy means of alcohol, ether or acetone. The silver is not in an ionizable form. Silver arsphenamine is a brownish-black powder, unstable in air; when properly dried it is free from lumps. It is readily soluble in water, yielding a dark brown solution (distinction from arsphenamine, sodium arsphenamine and ncoarsphenaminc) ; the solution has an alkaline reaction (distinction from arsplienaminc). The addition of dilute sodium hydroxide solution to 3 cc. of an aqueous solution of silver arsphenamine (1 in 500) produces no pre- cipitate (distinction from arsphenatnine). On the addition of 1 cc. of sodium carbonate test solution to 1 cc. of silver arsphenamine solution (1 in 20) no precipitate is formed (distinction from arsphenamine). The addition of 1 cc. of saturated solution of sodium bicarbonate to 1 cc. of silver arsphenamine solution produces a precipitate. One cc. of an aqueous solution of silver arsphenamine solution (1 in 20) when slightly acidulated with dilute hydrochloric acid yields a precipitate (distinction from arsphenamine). This precipitate dissolves on the very careful addition of more acid; on heating no irritating odor of sulfur dioxide should be detected (distinction from ncoarsphenatnine). However, a large excess of hydrochloric acid yields a precipitate. The careful addition of 3 cc. of acetic acid test solution to 3 cc. of silver arsphenamine solution (1 in 20) produces a precipitate (distinction from arsphenamine), a portion of which dissolves on further addition of the acetic acid test solution. When 3 cc. of silver arsphenamine solution (1 in 20) is heated with a few crystals of potassium permanganate (witliout addition of alkali; distinction from arsphenamine), the per- manganate is reduced and ammonia is evolved which may be tested by placing a moistened piece of red litmus paper in the vapors: the litmus paper will turn blue. The precipitate thus formed may be treated with hot nitric acid test solution; the mixture is boiled for a few min- utes and then cooled, diluted and filtered: the filtrate will yield a pre- cipitate of silver chloride on the addition of hydrochloric acid (distinc- tion from arsphenamine, neoarsphenamine and sodium arsphenamine). The addition of 1 cc. of trinitrophenol (picric acid) test solution to 1 cc. of silver arsphenamine solution produces a yellow precipitate (distinc- tion from neoarsphenamine ) . The addition of 1 drop of ferric chloride test solution to 1 cc. of silver arsphenamine solution (1 in 500) produces a deepening of the brown color, with a slightly purplish tint (distinction from sodium arsphenamine) , the liquid finally becoming turbid; if a more concentrated solution of silver arsphenamine (1 in 20) is employed, an immediate precipitate is formed. The careful addition, drop by drop, of bromine water to 3 cc. of silver arsphenamine solution (1 in 250) produces a reddish coloration, which is discharged by an ARSENIC COMPOUNDS 89 excess of the reagent; there is also formed a precipitate which dissolves on addition of a large excess of concentrated ammonia water (distinc- tion from arsphcnamine, neoarsphenamine and sodium arsphenamine). To 1 cc. of silver arsphenamine solution (1 in 20) add 1 cc. of hydrogen peroxide test solution: a brown precipitate resembling silver oxide is formed and the supernatant liquid is almost colorless (distinction from arsphenamine, neoarsphenamine and sodium arsphenamine). To 1 cc. of silver arsphenamine solution (1 in 20) add 1 cc. of sodium chloride test solution: no precipitate forms (absence of ionizable silver). (A concentrated sodium chloride solution added to a strong solution of silver arsphenamine causes a precipitate to form, due to a "salting out" action.) Place about 0.2 Gm. of silver arsphenamine, accurately weighed, in an Erlenmeyer flask, and carry out the Lehman process (described in Pub. Health Rep. 33:1003 [June 21] 1918) through the point of digestion. While the solution is hot, add cautiously dilute hydrochloric acid solution in order to obtain the precipitation of silver chloride. Filter off the silver chloride through a tared asbestos Gooch crucible, wash well and weigh: From the weight of silver chloride, the per- centage of silver may be calculated. The filtrate from the silver chloride is carried on in the usual manner according to the Lehman method, thereby determining the arsenic content. The total silver content of the drug shall be from 12 to 14 per cent and the total arsenic content shall be not less than 19 per cent. To determine the toxicity, select not less than five healthy albino rats weighing between 100 and 150 Gm. (pregnant animals shall not be used) ; prepare a 2 per cent silver arsphenamine solution and inject the solution into the saphenous vein of each rat at a rate of not more than 0.5 cc. per minute. The rats shall not be anesthetized for the injection. At least 60 per cent of the series of animals injected with the maximum tolerated dose should survive forty-eight hours from the time of injection: The maximum tolerated dose shall not be below 0.14 Gm. per kilogram of body weight. Silver-Salvarsan. — A brand of silver arsphenamine-N. N. R. Manufactured by the Winthrop Chemical Co., Inc., New York. U. S. patent 1,127,603 (Feb. 9, 1915; expired). U. S, trademark 161,232. Licensed for interstate sale by the U. S. Treasury Department under the "act to regulate the sale of viruses, serums, toxins and analogous products" as conforming to the regulations for the control, sale and manu- facture of silver arsphenamine. Silver-Salvarsan, 0.1 Gm. Ampules. Silver-Salvarsan, 0.15 Gm. Ampules. Silver-Salvarsan, 0.2 Gm. Ampules. Silver-Salvarsan, 0.25 Gm. Ampules. Silver-Salvarsan, 0.3 Gm. Ampules. Silver-Salvarsan, 0.6 Gm. Ampules. SULFARSPHENAMINE. — Sulfarsphenamina. — The salt, disodium 3,3'-diamino-4,4'-dihydroxyarsenobenzene-A''- dimethylenesulfonate, NaOSO2CH2NH.OH.C6H3.As : As.CeHs OH.NH,CH202SONa, with inert salt. Sulfarsphenamine con- tains not less than 19 per cent of arsenic (As). According to claims, it differs from neoarsphenamine in having two side chains instead of one, and in that the sulfur has a valence of four (with an extra oxygen atom) and not two as in neoarsphenamine. Actions and Uses. — The same as those of neoarsphenamine; it is probably somewhat more stable in solution in the presence of air, and it permits of intramuscular injection. In terms of percentages there seems to be a higher incidence of reactions 90 NEW AND NONOFFICIAL REMEDIES following the use of sulfarsphenamine, far more, in fact, than after the use of the other arsenicals employed in the treatment of syphilis. These reactions consist in (a) dermatitis, (b) hemorrhagic eruptions, (c) meningo-vascular reactions, (d) aplastic anemias, some of them even of agranulocytic angina and often with lethal exitus. All patients under treatment with sulfarsphenamine should be followed closely by the physician for evidence of reaction. The drug probably has a place, how- ever, and occasionally can be used by the intramuscular route in the treatment of heredosyphilis and in certain cases where the patient has such poor veins that intravenous therapy is out of the question. Dosage. — The maximum dosage by any route should probably not exceed 0.4 Gm., or at most 0.5 Gm. of the dry substance. For intramuscular or subcutaneous use the drug is dissolved in sterile, freshly distilled water in the proportion of about 0.1 Gm. to 0.3 cc, the total volume being not more than 1.0 to 2.0 cc. There is probably less local reaction where a minimum of diluent is employed. For intravenous use the drug should be diluted in the proportion of 0.1 Gm. to not less than 1.0 and preferably, 4.0 cc, or more, the total volume amounting to 5.0 to 20.0 cc. or more. Sulfarsphenamine is an orange-yellow powder possessing an odor resembling that of sulfur dioxide and arsine. It is readily soluble in water yielding a yellow solution which is acid to litmus (distinction from neoarsphenamine, which is neutral, and sodium arsphenamine, zvhich is alkaline). On standing over night, the solution darkens and a precipitate is formed. A freshly prepared solution of sulfarsphenamine (1 in 100) yields no immediate precipitate on the addition of diluted acetic acid, whereas neoarsphenamine yields a precipitate sooner (distinction from arsphen- amine). The general reactions with silver nitrate and ferric chloride, the qualitative tests for the presence of sulfur, are the same as those described under neoarsphenamine. The arsenic content of sulfarsphenamine may be estimated according to the Lehman m&H\o6. {Public Health Reports 33:1003 [June 21] 1918). The total arsenic content of the drug shall not be less than 19 per cent. When tested by the method used for arsphenamine but omitting the use of sodium hydroxide in preparing this solution, 60 per cent of the albino rats should survive 0.3 Gm. per kilogram of body weight for three days when the drug is administered intravenously as a 4 per cent solution. Sulpharsphenamine-Abbott. — A brand of sulfarsphen- amine-N. N. R. Manufactured by the Dermatological Research Laboratories, branch ot the Abbott Laboratories, North Chicago, 111., under U. S. patent 1,024,993 (April 30, 1912; expired) by license of the Chemical Foundation, Inc. Sulpharsphenamine-Abbott, 0.1 Gm. Ampules. Sulpharsphenamine-Abbott, 0.2 Gm. Ampules. Sulpharsphenamine-Abbott , 0.3 Gm. Ampules. Sulpharsphenamine-Abbott, 0.4 Gm. Ampules. Sulpharsphenamine-Abbott, 0.5 Gm. Ampules. Sulpharsphenamine-Abbott, 0.6 Gm. Ampules. Sulpharsphenamine-Abbott, 0.8 Gm. Ampules. ARSENIC COMPOUNDS 91 Sulpharsphenamine-Merck. — A brand of sulfarsphen- amine-N. N. R. Manufactured by Merck & Co. Inc., Rahway, N. J., under U. S. patent 1,024,993 (April 30, 1912; expired) by license of the Chemical Founda- tion, Inc. Sulpharsphcnamine-Merck, 0.1 Cm. Ampules. Sulpharsphenainine-Merck, 0.2 Gm. Ampules. Sulpharsphenamine-Merck, 0.3 Gm. Ampules. Sulpharsphenamine-Merck, 0.4 Gm. Ampules. Sulpharsphenamine-Merck, 0.5 Gm. Ampules. Sulpharsphenamine-Merck, 0.6 Gm. Ampules. Sulpharsphenamine-Mallinckrodt. — A brand of sulfars- phenamine-N. N. R. Manufactured by the Mallinckrodt Chemical Works, St. Louis, under U, S. patent 1,024,993 (April 30, 1912; expired) by license from the Chemical Foundation, Inc. Sulpharsphenamine-Mallinckrodt, 0.1 Gm. Ampules. Sulpharsphenamine-Mallinckrodt, 0.2 Gm. Ampules. Sulpharsphenamine-Mallinckrodt, 0.3 Gm. Ampules. Sulpharsphenamine-Mallinckrodt, 0.4 Gm. Ampules. Sulpharsphenamine-Mallinckrodt, 0.5 Gm. Ampules. Sulpharsphenamine-Mallinckrodt, 0.6 Gm. Ampules. Sulpharsphenamine-Winthrop. — A brand of sulfarsphen- amine-N. N. R. Manufactured by the Winthrop Chemical Co., Inc., New York, under U. S. patent 1,024,993 (April 30, 1912; expired) by license from the Chemical Foundation, Inc. Sulpharsphenamine-Winthrop, 0.1 Gm. Ampules. Sulpharsphenamine-Winthrop, 0.15 Gm. Ampules. Sulpharsphenamine-WintJirop, 0.3 Gm. Ampules. Sulpharsphenamine-Winthrop, 0.45 Gm. Ampules. Sulpharsphenamine-Winthrop, 0.6 Gm.. Ampules. Sulpharsphenamine-Winthrop, 0.75 Gm. Ampules. Sulpharsphenamine-Winthrop, 0.9 Gm. Ampules. Sulpharsphenamine-Winthrop, 3.0 Gm. Ampules. Sulpharsphenamine-Searle. — A brand of sulfarsphen- amine-N. N. R. Manufactured by G. D. Searle & Co., Chicago, under U. S. patent 1,024,993 (April 30, 1912; expired) by license of the Chemical Founda- tion, Inc. Sulpharsphenamine-Searle, 0.1 Gm. Ampules. Sulpharsphenamine-Searle, 0.2 Gm. Ampules. Sulpharsphenamine-Searle, 0.3 Gm. Ampules. Sulpharsphenamine-Searle, 0.4 Gm. Ampules. Sulpharsphenamine-Searle, 0.5 Gm. Ampules. Sulpharsphenamine-Searle, 0.6 Gm. Ampules. Sulpharsphenamine-Squibb. — A brand of sulfarsphen- amine-N. N. R. Manufactured by E. R. Squibb & Sons, New York, under U. S. patent 1,024,993 (April 30, 1912; expired) by license of the Chemical Foundation, Inc. Sulpharsphenamine-Squibb, 0.1 Sulpharsphenamine-Squibb, 0.2 Sulpharsphenamine-Squibb, 0.3 Sulpharsphenamine-Squibb, 0.4 Sulpharsphenamine-Squibb, 0.5 Sulpharsphenamine-Squibb, 0.6 Sulpharsphenamine-Squibb, 0.9 Sulpharsphenamine-Squibb, 3.0 Gm. Ampules. Gm. Amptdes. Gm. Ampules. Gm. Ampules. Gm. Ampules. Gm. Ampules. Gm. Ampules. Gm. . Ampules. 92 NEW AND NONOFFICIAL REMEDIES Compounds Containing Pentavalent Arsenic ACETARSONE.— Acetylaminohydroxyphenylarsonic Acid. — HO.CH3CONH.C6H3.As:0:(OH)2.— The acetyl derivative of 3-amino-4-hydroxyphenyl-l-arsonic acid. — Acetarsone con- tains from 27.1 to 27.4 per cent of arsenic (As). Actions and Uses. — Acetarsone has been reported to produce favorable effects in the treatment of amebic dysentery. It is claimed to yield satisfactory results in the eradication both of dysenteriae cysts and encysted flagellates, and for general amebic dysentery. Acetarsone is useful as a means of medica- tion of the vagina in the treatment of Trichomonas vaginitis. Its use in the treatment of sarcoid has been recommended by various dermatologists. Acetarsone has been proposed for use both in prophylaxis and in treatment in certain cases of syphilis, but the evidence is thus far inconclusive. Its use in amebic infections undoubtedly is of value, though still in the experi- mental stage. In using acetarsone, the physician should remem- ber that he is working with a rather toxic arsenical preparation, which may give rise to gastro-intestinal symptoms and hepatitis as well as to the same cutaneous disturbances that are found with the arsphenamines, for example, urticaria, erythema of various types and even hemorrhagic eruptions. At the least sign of intolerance the physician should discontinue the use of the drug for the time being. Dosage. — Orally, 0.25 Gm. for adults ; two or three doses a day for a period of seven days have been reported to give satis- factory results. For Trichomonas vaginitis, use locally in the vagina a powder containing 12^^ per cent acetarsone in a mixture of equal parts of kaolin and sodium bicarbonate. Single dose 4 Gm. — 1 teaspoonful of the mixture containing 0.5 Gm. Acetarsone. Acetarsone is a white, odorless powder, having a slightly acid' taste. It is slightly soluble in water and alcohol and readily soluble in solu- tions of alkalis or alkaline carbonates. It is stable at ordinary tempera- tures. To a solution of 1 Gm. of acetarsone in 10 cc. of sodium hydroxide solution and 10 cc. of water, add 2 Gm. of sodium hydrosulfite and warm the mixture to about 50 C. : a light yellow precipitate is formed, which is soluble in an excess of sodium hydroxide. To a solution of 0.5 Gm. of acetarsone in 10 cc. of water and a slight excess of ammonia water, add magnesia mixture: no precipitate forms (absence of inor- ganic arsenates) ; but on heating the mixture for some time, a pre- cipitate is produced. Dissolve 1 Gm. of acetarsone in 10 cc. of sodium carbonate solution: no undissolved residue remains. To 1 Gm. of acetarsone add 10 cc. of hydrochloric acid (5 per cent), shake well and filter. To the filtrate add two drops of solution of potassium bichromate (3 per cent) : no red or brown color is produced (unacetyl- ized amino-acids). Shake 0.5 Gm. of acetarsone with 10 cc. of diluted nitric acid for five minutes and then filter: the filtrate becomes at most slightly turbid on the addition of a few drops of silver nitrate solution. Incinerate 0.5 Gm. of acetarsone: not more than 0.2 per cent of residue remains. Dry a weighed quantity of acetarsone to constant weight at 100 C.: the loss does not exceed 0.5 per cent. Determine the arsenic of acetarsone by Lehmann's method: the arsenic content corresponds to from 27.1 to 27.4 per cent. ARSENIC COMPOUNDS 93 Acetarsone-Abbott. — A brand of acetarsone-N. N. R. Manufactured by the Abbott Laboratories, North Chicago, 111. No U. S. patent or trademark. Tablets Acetarsone-Abbott, 0.25 Gm. Stovarsol. — A brand of acetarsone-N. N. R. Manufactured by Merck & Co. Inc., Rahway, N. J., under license of Les Etablisseraents Poulenc Freres, Paris. No U. S. patent. U. S. trademark 177,082. Stovarsol Tablets 0.25 Gm. CARBARSONE. — /j-Carbamido-phenylarsonic acid.— A-Car- bamido-benzenearsonic acid.— NH2CONH.C6H4AS : O :(OH)o.— The A^-carbamyl derivative of [p] arsanilic acid. Carbarsone contains from 28.1 to 28.8 per cent arsenic (As). Actions and Uses. — Carbarsone is proposed for the treatment of intestinal amebiasis. It is administered usually by mouth ; in acute amebic dysentery or in resistant cases with motile amebas in the stools, retention enemas may be employed. While carbarsone is said to be less toxic than acetarsone and serious untoward effects appear to be uncommon, cutaneous distur- bances and other reactions common to arsenic compounds have been observed. It has been suggested that owing to its chemical structure (in which a modified amido group is in para position to the arsenic atom, similar to the arrangement in tryparsamide) the administration of carbarsone may lead to injury of the optic nerve. While visual disturbances appear to be quite rare, the possibility of their occurrence should nevertheless be kept in mind during the therapeutic use of the drug. A moderate increase in intestinal activity may be observed. Carbarsone, in common with other arsenicals, should ordinarily not be employed in the presence of hepatitis or kidney damage. Excre- tion of the administered arsenic is relatively slow ; suitable rest periods must therefore be interposed in the treatment to prevent cumulative effects. The diagnosis of amebiasis depends on the observation of motile forms or cysts of Endamoeba histolytica in stool speci- mens (repeated examinations are often necessary) or their recovery by means of the proctoscope from the intestinal mucosa ; positive diagnosis can often be made by the latter procedure when stool examinations are negative, and this is considered to be the more satisfactory as well as the more rapid method of diagnosis in many cases. In view of the frequency of persistent infection in the absence of marked symptoms, adequate therapy includes reexaminations and repetitions of courses of treatment. Dosage. — Orally, for adults, the usual dose is 0.25 Gm. twice a day for ten days. If necessary this may be repeated following a ten day rest period. For children, the dosage may be reduced according to weight. As retention enemas, for adults, 2 Gm. of the drug dissolved in 200 cc. of warm 2 per cent sodium bicarbonate solution may be administered following a cleansing 94 NEW AND NONOFFICIAL REMEDIES alkaline enema every other night for a maximum of five doses, if necessary. Because of the large dosage employed (a total of 10 Gm. over a period of nine days) oral administration should be interrupted during this interval. Manufactured by Eli Lilly & Company, Indianapolis. No U. S. patent. "Carbarsone" is a registered U. S. trademark but the firm disclaims proprietary rights to the name. Vials Carbarsone, 2 Gm. (31 grains). Pulvules Carbarsone, 0.25 Gm. (3H grains). Carbarsone is a white, almost odorless powder, having a slightly acid taste. It is slightly soluble in water, and in alcohol and nearly insoluble in ether and chloroform; freely soluble in alkalis and alkaline carbonates. The water solution yields an acid reaction to litmus paper. Transfer 1 Gm. of carbarsone to a suitable test tube, dissolve in a solution containing 10 cc. of sodium hydroxide solution and 10 cc. of water; add 2 Gm. of sodium hydrosulfite and warm the mixture to 50 C. : a light yellow precipitate is formed in an excess of sodium hydroxide solution (distinction from acetarsone). Dissolve 0.50 Gm. of carbarsone in 2 cc. of amrnonia water, dilute to 5 cc. with water and add 3 cc. of magnesia mixture solution: no precipitate forms within one half hour {absence of inorganic arsen- ates); allow the solution to stand for some time longer or heat the solu- tion for some time: a precipitate is produced. Add 10 cc. of sodium carbonate solution to 1 Gm. of carbarsone in a test tube and gently agitate the mixture: a complete solution results in five minutes. Shake 0.5 Gm'. of carbarsone for five minutes with 10 cc. of diluted nitric acid, filter the mixture, and add a few drops of silver nitrate solution to the filtrate: at most only a very slight turbidity is produced within five minutes. Carbarsone melts with decomposition at 169 to 171 C. (the U. S. P. melting point determination method is to be used). Transfer 0.4 Gm. of carbarsone to a test tube, add 5 cc. of_ 20 per cent sodium hydroxide, stopper with a slotted cork from which is suspended a strip of moist red litmus paper, and heat gently: the litmus paper turns blue. Dissolve 0.50 Gm. of carbarsone in 2 cc. of ammonia water and dilute to 10 cc. with water. This solution conforms to the test for heavy metals when treated according to U. S. P. XI, p. 447, beginning with "warm it to about 50 C, etc." [The test for absence of arsanilic acid as described for tryparsamide, N. N. R., 1934, is not applicable to this compound.] Incinerate 0.5 Gm. of carbasone: not more than 0.1 per cent residue remains. Heat about 0.4 Gm., accurately weighed, of carbarsone for twenty-four hours at 80 C. : the loss in weight does not exceed 1.1 per cent. Determine the arsenic of carbarsone by the method for arsenic in arsphenamine U. S. P. XI, p. 74: the arsenic (As) content corresponds to from 28.1 to 28.8 per cent of the weight of the sample. Transfer about 0.5 Gm. of carbarsone, accurately weighed, to a 500 cc. Kjeldahl flask. Determine the nitrogen content according to the method of Medical War Manual No. 6 Laboratory Methods of the U. S. Army, Second Edition Revised, page 222, beginning with "Add 20 cc. of concentrated H2SO4. . . ." The nitrogen content is not less than 10.7 per cent, nor more than 11 per cent of the weight of the sample. SODIUM CACODYLATE.— "Contains not less than 72 per cent and not more than 75 per cent of Na(CH3)2As02, the remainder consisting chiefly of water." — U. S. P. For standards see the U. S. Pharmacopeia under Sodii Caco- dylas. Cheplin's Sodium Cacodylate 0.05 Gm. (^ grain), 1 cc: Benzyl alcohol 1 per cent is added for its local anesthetic effect. Prepared by the Cheplin Biological Laboratories, Inc., Syracuse, N. Y. ARSENIC COMPOUNDS 95 Benzyl Syracuse, N. Y. 1 cc. : Benzyl Syracuse, N. Y. 1 cc. : Benzyl Syracuse, N. Y. 1 cc. : Benzyl Cheplin's Sodium Cacodylate 0.1 Gm. (1^2 grains), 1 cc. alcohol 1 per cent is added for its local anesthetic effect Prepared by the Cheplin Biological Laboratories, Inc., Cheplin's Sodium Cacodylate 0.2 Gm. (3 grains), alcohol 1 per cent is added for its local anesthetic effect. Prepared by the Cheplin Biological Laboratories, Inc., Cheplin's Sodium Cacodylate 0.3 Gm. (5 grains), alcohol 1 per cent is added for its local anesthetic effect. Prepared by the Cheplin Biological Laboratories, Inc., Cheplin's Sodium Cacodylate 0.5 Gm. (ly^ grains), alcohol 1 per cent is added for its local anesthetic effect. Prepared by the Cheplin Biological Laboratories, Inc., Syracuse, N. Y. Cheplin's Sodium Cacodylate 1.0 Gm. (15y2 grains), 2 cc: Benzyl alcohol 1 per cent is added for its local anesthetic effect. Prepared by the Cheplin Biological Laboratories, Inc., Syracuse, N. Y. Ampoule Solution Sodium Cacodylate 0.19 Gm. (3 grains), 1 cc. Prepared by the Lakeside Laboratories, Inc., Milwaukee. Ampoule Sodiiim Cacodylate 0.243 Gm. (3}i grains), 5 cc. Prepared by the Lakeside Laboratories, Inc., Milwaukee, Wis. D. & Co., 0.2 Gm. (3 D. & Co., 0.3 Gm. (5 Glaseptic Ampoules Sodium Cacodylate-P. grains), 1 cc. Prepared by Parke, Davis & Co., Detroit. Glaseptic Ampoules Sodium Cacodylate-P. grains), 1 cc. Prepared by Parke, Davis & Co., Detroit. Glaseptic Ampoules Sodium Cacodylate-P. grains), 1 cc. Prepared by Parke, Davis & Co., Detroit. Glaseptic Ampoules Sodium Cacodylate-P. grains), 1 cc. Prepared by Parke, Glaseptic A»ipoulcs grains), 1 cc. Prepared by Parke, Glaseptic Ampoules grains), 2 cc. Prepared by Parke, Davis & Co., Detroit. Sodium Cacodylate-P. Davis & Co., Detroit. Sodium Cacodylatc-P. D. & Co., 0.45 Gm. (7 D. &■ Co., 0.1 Gm. (VA D. &■ Co., 0.13 Gm. (2 D. & Co., 1 G> (15] Davis & Co., Detroit. Ampules, Sodium Cacodylate-Miilford, ^4 grain, 1 cc. Prepared by Sharp & Dohme, Philadelphia. Ampules Sodium Cacodylatc-Mulford, lYi grains, 1 cc. Prepared by Sharp & Dohme, Philadelphia. Ampules Sodium Cacodylate-Mulford, 2 grains, 1 cc. Prepared by Sharp & Dohme, Philadelphia. Ampules Sodium Cacodylate-Mulford, 3 grains, 1 cc. Prepared by Sharp & Dohme, Philadelphia. Ampules Sodium Cacodylate-Mulford, 5 grains, 1 cc. Prepared by Sharp & Dohme, Philadelphia. Ampule's Sodium Cacodylate-Mulford, 7 grains, 1 cc. Prepared by Sharp & Dohme, Philadelphia. Ampules Sodium Cacodylate-Mulford, 151/2 grains, 2 cc. Prepared by Sharp & Dohme, Philadelphia. Ampul Solution Sodium Cacodylate 0.2 Gm. (3 grains), 1 cc. Prepared by the U. S. Standard Products Co., Woodworth, Wis. Ampul Solution Sodium Cacodylate 0.32 Gm. (5 grains), 1 cc. Prepared by the U. S. Standard Products Co., Woodworth, Wis. Ampul Solution Sodium Cacodylate 0.45 Gm. (7 grains), 1 cc. Prepared by the U. S. Standard Products Co., Woodworth, Wis. Ampul Solution Sodium Cacodylate 0.2 Gm. (3 grains), 5 cc. Prepared by the U. S. Standard Products Co., Woodworth, Wis. Ampul Solution Sodium Cacodylate 0.32 Gm. (5 grains), 5 cc. Prepared by the U. S. Standard Products Co., Woodworth, Wis. Ampul Solution Sodium Cacodylate 0.45 Gm. (7 grains), 5 cc. Prepared by the U. S. Standard Products Co., Woodworth, Wis. 96 NEW AND NONOFFICIAL REMEDIES SOLARSON. — Solution Chlorarsenol, 1 per cent. — A 1 per cent solution of ammonium heptenchlorarsonate CH3(CH2)4CC1 : CH.AsO.OH.ONH4, rendered isotonic by the addition of sodium chloride. Solarson contains from 0.255 to 0.275 Gm. of arsenic (As) in 100 cc. Actions and Uses. — In experiments on rabbits the toxicity of solarson, computed on the basis of its arsenic content, was found to be somewhat less than that of arsenic acid (H3ASO4) when given intravenously or subcutaneously : In dogs it was about the same. Repeated daily subcutaneous injections of an amount of solarson equivalent to 0.002 Gm. arsenic per kilogram was well tolerated by rabbits. An experiment on a dog showed that after the subcutaneous administration of a dose of solarson corresponding to 0.02 Gm. arsenic, the urine collected for twenty-four hours after the injection contained 0.0052 Gm. of arsenic and the feces in forty-eight hours 0.0012 Gm. ; this is taken to show that the arsenic of solarson is readily liberated in the system and is well utilized. It is claimed that solarson has an advantage over the cacodylates, in that its arsenic is better utilized, and over the arsenilates in that subcutaneous and intramuscular injections produce less pain and are less liable to produce toxic effects. Solarson is used as a means of obtaining arsenic effects in the treatment of anemia, chlorosis, malaria, neuroses and dermatoses. Dosage. — From 1 to 2 cc. subcutaneously or intramuscularly. Manufactured by Winthrop Chemical Co., Inc., New York. U. S. patent 1,201,692 (Ausr. 17, 1916; expired). U. S. trademark 110,626. Solarson Ampules, 1 cc. Solarson is prepared by neutralization of heptenchlorarsonic acid with ammonium hydroxide and dilution with sufficient water to produce a 1 per cent solution of ammonium heptenchlorarsonic acid; sufficient sodium chloride is added to render the solution isotonic. The heptenchlorarsonic acid used in the preparation of solarson responds to the following tests: It melts at 114 to 115 C. and contains 29.21 per cent of arsenic (As). To determine the arsenic content of solarson, treat about 1 Gm. of solarson, accurately weighed, with 5 cc. of arsenic-free nitric acid and 5 cc. of arsenic-free sulfuric acid. Boil the mixture until white fumes appear; allow to cool and add 50 cc. of water and boil for five minutes. Allow the liquid to cool and bring the quantity up to 100 cc. with distilled water. Add 50 cc. of this liquid in portions to a generat- ing Marsh apparatus. Collect the arsenic in a weighed arsenic tube 15 cm. long, heated to redness in two places and cooled in two other places by water-soaked wicks. Continue the collection of the arsenic for six hours, cool the arsenic tube and weigh it. The arsenic found in the solarson is not less than 0.255 Gm. nor more than 0.275 Gm. per hundred cubic centimeters. TRYPARSAMIDE. — "Sodium A^-phenylglycinamide-/'- arsonate, containing, when dried to constant weight at 110 C., not less than 25.1 per cent and not more than 25.5 per cent of arsenic (As)."-[/. S. P. ARSENIC COMPOUNDS 97 For standards see the U. S. Pharmacopeia under Trypars- amidum. Actions and Uses. — Tryparsamide was first used as a tryp- anocidal agent especially in the treatment of trypanosomiasis due to T. gamhiense but is now used as well in certain cases of syphilis of the central nervous system. Tryparsamide has some spirocheticidal activity and has an unusual power of therapeutic penetration, especially in case of the central nervous system. The best results seem to have been obtained in patients with early dementia paralytica; it is estimated that perhaps from 40 to 50 per cent of such cases have shown varying degrees of symptomatic improvement. Tabetic affections have responded less satisfactorily, and patients with dementia paralytica with advanced mental and physical deteri- oration have shown little or no improvement ; on the other hand, the drug may hasten the progress of the disease in such cases. Its use is considered inadvisable in forms of syphilis other than that of the central nervous system, and it is held by som,e that it should be used in cerebrospinal syphilis only in cases that have failed to respond favorably to the arsphenamines. It is being used quite extensively as one of the follow up treatments after malaria therapy in syphilis of the central nervous system. The toxic effects of tryparsamide resemble those of other pentavalent arsenic compounds ; the worst of these is the ten- dency to produce amblyopia, but cases of jaundice, of agranulo- cytosis, and of toxic hepatitis have also been reported. Before using the drug, careful consideration should be given to the frequent production of visual injury, which may be serious and permanent. This caution is especially important if the neuro- syphilis has involved the optic nerve. The eyeground fields, including color fields, should always be mapped out before its use is made. Sometimes after one or two injections the patient will complain of blurred vision for a few days. Generally if treatment is discontinued for a week or so and then the injec- tions are reinstituted, there will be no further difficulty. The drug is said to "have no virtues in ophthalmic syphilis." Dosage. — From 1.0 to 3.0 Gm. for adults, depending on the purpose for which the drug is used. In general, the dose should not exceed 0.04 to 0.05 Gm. per kilogram of body weight, and such doses should not be repeated at intervals of less than one week. Tryparsamide may be administered sub- cutaneously, intramuscularly or intravenously, though the intra- venous administration is generally employed. The drug is dissolved in sterile water or physiologic solution of sodium chloride. Tryparsamide should never be administered by mouth. Manufactured by Merck & Co. Inc., Rahway, N. J., under U. S. patents 1,280,119, 1,280,120, 1,280,121, 1,280,122, 1,280,123, 1,280,124 and 1,280,126 (Sept. 24, 1918; expired) by license of the Rockefeller Institute for Medical Research. U. S. trademark 186.022. 98 NEW AND NONOFFICIAL REMEDIES ATROPINE DERIVATIVES AND ANALOGUES Synthetic Mydriatics The usefulness of atropine is somewhat diminished by the fact that it affects, simultaneously, so many organs ; on the eye its effects continue much longer than is in many cases desirable. Many attempts have been made to secure drugs of the atropine type with more specific actions or drugs that have a more transitory effect upon the eye. One of these drugs (homatropine) is a synthetic alkaloid analogous to atropine, the only difference being that it contains mandelic acid instead of tropic acid in combination with atropine; euca- tropine is a combination of mandelic acid and a base similar to that contained in beta-eucaine. EUCATROPINE. — Eucatropina. — Eucatropine Hydro- chloride. — Euphthalmine. — Phenylglycolymethylvinyldiaceton- alkamine Hydrochloride. — C5H6N(CH3)4(C6H5CHOH.COO) HCl = the l,2,6,6-tetramethyl-4-mandeloxypiperidine hydro- chloride. Eucatropine was first introduced as euphthalmine. Actions and Uses. — Eucatropine produces prompt mydriasis free from anesthetic action, pain, corneal irritation or increase in intra-ocular tension. It has little or no eft'ect on accom- modation, and such effect as it has disappears more rapidly than that of atropine, cocaine, homatropine, etc. In its effects on the general system, eucatropine, very closely resembles atro- pine. It is useful as an aid in ophthalmoscopic examinations in place of atropine, homatropine, etc. Dosage. — From 2 to 3 drops of from a 5 to 10 per cent solution, according to the age of the patient and the nature of the case, are instilled into the eye. Eucatropine is a white, granular, odorless powder; permanent in the air. It is very soluble in water; freely soluble in alcohol and chloro- form; insoluble in ether. Eucatropine does not melt below 183 C. The aqueous solution of eucatropine (1 in 50) is clear and colorless and is neutral to litmus. Aqueous solutions of eucatropine (1 in 50) are precipitated by sodium carbonate solution, potassium mercuric iodide solution, iodine solution, picric acid solution and many other reagents for the alkaloids. Add a few drops of nitric acid to about 0.05 Gm. of eucatropine, evaporate the mixture to dryness on a water bath, cool the residue and add a few drops of alcoholic potassium hydroxide solution together with a fragment of potassium hydroxide: no violet color results (distinction from atropine, scopolamine or hyoscyamine). Incinerate about 0.5 Gm. of eucatropine, accurately weighed: the^ ash amounts to not more than 0.1 per cent. Dissolve about 1 Gm. of eucatropine, accurately weighed, in 10 cc. of water, make alkaline with ammonia water and shake with successive portions of ether until extraction is complete, washing the ether layer each time with water and adding the washings to the original solution before the next extraction; allow the solvent to evaporate spontaneously, dry the residue to constant weight at 80 C. and weigh: the residue of eucatropine base is not less than 86 per cent. Recrystallize the free base obtained as above from petroleum ether: The crystals do not melt below 111 C. BARBITAL COMPOUNDS 99 Euphthalmine Hydrochloride. — A brand of eucatropine- N. N. R. Manufactured by Schering-Kahlbaum A. G.. Berlin, Germany (Scherinj; & Glatz, Inc., New York, distributor). U. S. patent 663,754 (expired). U. S. trademark 35,541. HOMATROPINE HYDROCHLORIDE. — Homatro- pinae Hydrochloridum. — CwHaiOsNHCl. — The hydrochloride of the alkaloid homatropine, obtained by the condensation of tropine and mandelic acid. Actions and Uses. — Homatropine hydrochloride is given for the same indications as the hydrobromide. Dosage. — It is applied to the eye in 1 per cent solution. Homatropine hydrochloride occurs as small white crystals, solujjle in water and alcohol and melting at from 216 to 217 C. The color test for the identification of homatropine hydrochloride and the tests showing the absence of impurities should agree with those described in the U. S. Pharmacopeia under homatropine hydrobromide. Homatropine Hydrochloride-Merck. — A brand of homa- tropine hydrochloride-N. N. R. Merck & Co. Inc., Rahway, N. J., distributor. No U. S. patent or trademark. Homatropine Hydrochloride-Roche. — A brand of lioma- tropine hydrochloride-N. N. R. Manufactured by F. Hoffmann-LaRoche & Co., Basle, Switzerland (Hofifmann-LaRoche, Inc., Nutley, N. J.). No U. S. patent or trademark. BARBITAL AND BARBITAL COMPOUNDS Barbital (diethylbarbituric acid), which was introduced under the name of "veronal," is chemically related to urea and the carbamate hypnotics : NHo NH2 NH-CO C2H., y / / \ / oc oc oc c \ \ \ /- \ NH2 OQH5 NH-CO C.oHr, Urea Ethyl carbamate Diethylbarbituric acid (Urethane) (Barbital) The ethyl groups may be replaced by other alkyl or aryl radicals tc form a large number of derivatives. Compounds in which one of the ethyl groups of diethylbarbituric acid is replaced by an isoamyl group (amytal), a normal butyl group (neonal), an wo-propyl group (ipral), a cyclo-hexenyl group (phanodorn), an n-hexyl group (ortal), a 1-methyl butyl 100 NEW AND NONOFFICIAL REMEDIES group (pentobarbital), and a phenyl group (phenobarbital, lumi- nal), and those in which both of the ethyl groups are replaced by two allyl groups (dial), in which one ethyl group is replaced by uo-propyl and the other by a brom-allyl group (nostal), and in which one ethyl group is replaced by an iso-huty\ and the other by an allyl group (sandoptal), are accepted for N. N. R. These "acids" are only sparingly soluble in water ; but freely soluble compounds are formed by substitution of sodium for the hydrogen of one of the NH groups of such acids to make sodium barbital (soluble barbital-U. S. P.). sodium phenobarbital (soluble phenobarbital-U, S. P.), pento- barbital sodium, and others described in N. N. R. Actions and Uses. — Barbital and its derivatives are effective sedatives and hypnotics, and are used as such in simple insomnia, hysteria, neurasthenia, thyroid disease and chorea, in epilepsy in the intervals between the seizures, in mental disturbances and in impending delirium tremens. They also augment the action of analgesics such as aminopyrine, acetophenetidin and acetylsalicylic acid, and they are used in combination with these analgetics for the relief of pain, especially of neuralgic character. They are decidedly more actively hypnotic, and somewhat more analgetic than chloral hydrate ; they do not produce local irritation and the taste is not disagreeable. The margin between the ordinary therapeutic dose and the toxic dose is somewhat wider than that with chloral hydrate, and small therapeutic doses have little effect on the blood pressure and respiration. Several of the derivatives of barbital are more actively hypnotic than the parent substance and may be pre- ferred, especially as a sedative; but there is no satisfactory evidence that the margin between the therapeutic and toxic doses of these derivatives is wider than in the case of barbital itself. The action is somewhat slower than with chloral hydrate, but more rapid than with sulfonmethane. In the absence of pain, small doses usually induce sleep within half an hour. The sleep lasts for four to eight hours, varying with individuals, with the drug used and with the dose. The patient generally wakens refreshed, but occasionally there are lassitude, vertigo, headache, nausea and diarrhea on the fol- lowing day even after moderate doses. Skin eruptions are sometimes observed. Fatal collapse (by peripheral paralysis of the blood vessels) has occurred after relatively small doses. Toxic doses cause lowered body temperature, depression of the respiration and circulation, and feeble heart beat. There is long-continued stupor, sometimes interrupted by excitement. The condition has been confused with uremia, epidemic enceph- alitis and opium poisoning. The slower the excretion of the various members of this group, the more lasting is the action, and with very slow excretion ordinary doses may produce cumulative toxic effects after some time. It is therefore safer to intermit the administration at least weekly. Continued use BARBITAL COMPOUNDS 101 may lead to habitual addiction. Barbital preparations are usually administered orally or rectally. In rare instances intra- venous injections may be used (/. A. M. A. 97:1886 [Dec. 19] 1931; 101:208 [July 15] 1933), but this method does not offer any advantages except when oral administration is not feasible or when unusually prompt action is imperative. Recent experi- mental work indicates that fairly large doses are effective against poisoning by the local anesthetics like cocaine and pro- caine, and their salts, and against strychnine and picrotoxin. ALURATE. — Allylisopropylbarbituric acid. — Allylisopropyl- malonyl urea. — (C3H5)(C3H7)C-CONHCONH-CO. Alurate differs from barbital (diethylbarbituric acid) in that both of the ethyl groups of the latter are replaced, one by an allyl group and the other by an isopropyl group. Actions and Uses. — The actions and uses of alurate are essen- tially similar to those of barbital, but alurate is more active than barbital and is used in correspondingly smaller doses. Fractional doses are used as a sedative and larger doses as a hypnotic. Therapeutic doses act on the higher centers of the brain and are claimed not to exert any apparent injurious effect on the heart, circulation or kidneys. Dosage. — For mild cases of insomnia, 0.065 Gm. (1 grain) may be administered at bedtime. In obstinate cases, 0.13 Gm. (2 grains) may be given. Manufactured by Hoffmann-LaRoche, Inc., Nutley, N. J. U. S. patent 1,444,802 (Feb. 13, 1923; expires 1940). U. S. trademark 230,059. Alurate Tablets, 1 gr. Elixir Alurate: Each fluidrachm contains alurate J4 grain (approxi- mately 0.9 Gm. per hundred cubic centimeters) in a palatable elixir con- taining alcohol, 20 per cent. Alurate occurs as a fine, white, odorless, crystalline powder, with a slightly bitter taste; completely soluble in alcohol, chloroform and ether; very slightly soluble in cold water; insoluble in the paraffin hydrocar- bons. A saturated aqueous solution is acid to litmus paper. Alurate melts at 140 to 141.5 C. Place about 0.3 Gm. of alurate in a glass stoppered cylinder, add a mixture of 1 cc. of normal sodium hydroxide solution and 5 cc. of water, shake the contents for one minute, filter through paper and divide into two portions; to one portion add 1 cc. of mercuric chloride solution: a white precipitate results, soluble in an excess of ammonia water; to the other portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in an excess of ammonia water. Boil about 0.5 (jm. of alurate with 5 cc. of a 25 per cent sodium hydroxide solu- tion: it is decomposed with the evolution of ammonia. Dissolve about 0.1 Gm. of alurate in 1 cc. of sulfuric acid: not more than a slight yellow color results. Place about 1 Gm. of alurate in a 25 cc. glass stoppered cylinder, add 10 cc. of water, shake the mixture for one minute, filter through paper and divide into two portions; to one portion add 1 cc. of acetic acid and 0.5 cc. of a saturated bromine water: an immediate discoloration occurs; to the other portion add 0.1 cc. of tenth- normal potassium permanganate solution: a yellow color appears imme- diately, turning to brown. Boil about 0.5 Gm. of alurate with SO cc. of water for two minutes: no odor develops; cool and filter: separate portions of 10 cc. each of the filtrate yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. 102 NEW AND NONOFFICIAL REMEDIES of silver nitrate solution (chloride) f no turbidity with 1 cc. of diluted nitric acid and 1 cc. of barium nitrate solution (sulfate); no colora- tion or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Incinerate about 1 Gm. of alurate, accurately weighed: there is not more than 0.1 per cent residue. Dissolve about 0.5 Gm. of alurate, accurately weighed in 25 cc. of previously neutralized alcohol, dilute with an equal volume of water previously boiled to remove carbon dioxide and titrate with tenth-normal sodium hydroxide solution, using thymolphthalein as an indicator: the amount of tenth-normal sodium hydroxide solution consumed corresponds to not less than 98.5 per cent nor more than 101.5 per cent allylisopropylbarbituric acid. AMYTAL. — Isoamylethylbarbituric acid. — Isoamylethyl- malonylurea. — 2,4,6-trioxy-5-isoamylethylpyrimidin. — (CsHn) (GH5)CC0NHC0NHC0. Amytal differs from barbital (diethylbarbituric acid) in that one of the ethyl groups of the latter is replaced by an iso-amyl group in the former. Actions and Uses. — The actions and uses of amytal resemble those of barbital. It is proposed as a sedative and hypnotic in the control of insomnia and as a preliminary to surgical anesthesia. Dosage. — It is given orally in tablet form with water or hot milk. As a sedative: 0.02 to 0.04 Gm. (J/^ to ^ grain) two or three times daily. As a hypnotic: 0.1 to 0.3 Gm. (lJ/2 to 5 grains) one-half to one hour before sleep is desired. For use before local or general anesthesia the dosage ranges between 0.2 and 0.6 Gm. (3 to 10 grains), being determined by a large number of factors (age, etc.). It can be used safely for such purposes only by those who have had much experience and are familiar with the literature concerning such use. As an antispasmodic in tetanus, 0.4 to 0.8 Gm. (6 to 12 grains) may be required to control convulsions. In some patients bar- bital derivatives produce restlessness and excitement, and to these patients amytal should not be administered. Manufactured by Eli Lilly & Co., Indianapolis, Ind. U. S. patent 1,514,573 (Nov. 4, 1924; expires 1941). U. S. trademark 161,125. Tablets Amytal, y^ grain. Tablets Amytal, }4 Grain. Tablets Amytal, ^ grain. Tablets Amytal, li/2 grains. Amytal occurs as a white crystalline, odorless powder, with a slightly bitter taste; completely soluble in alcohol and ether; very slightly soluble in cold water and insoluble in the paraffin hydrocarbons. A saturated aqueous solution is acid to litmus paper. It melts at 153-155 C. Place 0.3 Gm, of amytal in a 25 cc. glass stoppered cylinder, add a mixture of 1 cc. normal sodium hydroxide solution and 5 cc. of water, shake the contents for one minute, filter through paper and divide into two portions; to one portion add 1 cc. of mercuric chloride solution: a white precipitate results, soluble in 10 cc, of ammonia water; to the other portion add 5 cc, of silver nitrate solution: a white precipitate results, soluble in 5 cc, of ammonia water. Boil 0.5 Gm. of amytal with 5 cc. of a 25 per cent sodium hydroxide solution: it is decomposed with the evolution of ammonia. Dissolve 0.1 Gm. of amytal in 1 cc. of sulfuric acid: the solution is colorless {readily carbonizable substances). Boil 0.5 Gm. of amytal with 50 cc. of water for two minutes: no odor develops; cool and filter: BARBITAL COMPOUNDS 103 separate portions of 10 cc. each of the filtrate yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution {chloride)-, no turbidity with 1 cc. of diluted nitric acid and 1 cc. of barium nitrate solution (sulfate); no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Incinerate about 1 Gm. of amytal, accurately weighed: the residue does not exceed 0.1 per cent. Dissolve about 0.5 Gm. of amytal accu- rately weighed in 25 cc. of previously neutralized alcohol; dilute with an equal volume of water and titrate with tenth-normal sodium hydroxide solution, using thymolphthalein as an indicator: the amount of tenth-normal sodium hydroxide solution consumed corresponds to not less than 98.5 per cent nor more than 101.5 per cent of isoamyl- ethylbarbituric acid. BARBITAL.— Diethylbarbituric Acid Barbitone.— Diethyl- nialonylurea.— For standards see the U. S. Pharmacopeia under Barbitalum. Actions and Uses. — See the preceding article, Barbital and Barbital Compounds. Barbital is quickly absorbed, especially when it is given in solution. Small doses induce sleep, appar- ently with little other effect, and are relatively safe ; but fatali- ties have followed its indiscriminate use. Dosage. — As hypnotic, 0.5 Gm. (8 grains), best prescribed in the form of powder to be given in hot fluid, such as hot milk, half an hour or an hour before bed time. Pills or tablets should be crushed before swallowing, to insure absorption. From 0.1 to 0.15 Gm. (ly^ to 2 grains) are used with anal- getics for the relief of pain. Barbital-Abbott. — A brand of barbital-U. S. P. Manufactured by Abbott Laboratories, North Chicago, 111. Barital-Mallinckrodt. — A brand of barbital-U. S. P. Manufactured by Mallinckrodt Chemical Works, St. Louis. Barbital-Merck. — A brand of barbital-U. S. P. Prepared by Merck & Co., Rahway, N. J. Veronal.— A brand of barbital-U. S. P. Manufactured by Winthrop Chemical Company, Inc., New York. U. S. patent 782,739 (Feb. 14, 1905; expired). U. S. trademark 40,115. Veronal Tablets, 5 grains. Elixir of Veronal: Each fluid drachm contains veronal 2 grains in a menstruum containing alcohol 33.5 per cent. DIAL-CIBA. — Diallylbarbituric acid. — Diallylmalonylurea. — 2,4,6-trioxy-5-diallylpyrimidin. — (C3H5)2CCONHCONHCO. Dial-Ciba differs from barbital (diethylbarbituric acid) in that both of the ethyl groups of the latter are replaced by allyl groups. Actions and Uses. — The actions and uses of dial-Ciba are essentially similar to those of barbital, but dial-Ciba is more active than barbital and it is used in correspondingly smaller doses. Fractional doses are used as a sedative and larger doses 104 NEW AND NONOFFICIAL REMEDIES as a hypnotic. Therapeutic doses act on the higher centers of the brain and exert no injurious action on respiration or circulation. The hypnotic action is induced within from one- half to one hour. Dosage. — As a sedative : 0.03 Gm. (^ grain) three or four times daily. As a hypnotic: 0.1 to 0.3 Gm. (1^ to 4j/2 grains) one-half to one hour before sleep is desired. Manufactured by the Society of Chemical Industry in Basle, Switzer- land (Ciba Company, Inc., New York, distributor). U. S. patent 1,042,265 (Oct. 22, 1912; expired). U. S. trademark 98204 and 126088. Elixir Dial-Ciba: Each 4 cc. (1 fluidrachm) contains 0.05 Gm. (3/^ grain) in a menstruum containing alcohol 25 per cent. Solution Dial-Ciba imth Urethane, Sterile Ampules, 1 cc: Each cubic centimeter contains dial-Ciba 0.1 Gm. (1^ grains), ethyl carbamate (urethane) 0.4 Gm. (6 grains), monoethylurea 0.4 Gm. (6 grains) and water q. s. Actions and Uses. -^The same as those of dial-Ciba; it is claimed that the ethyl carbamate and monoethylurea are used as solvents, and, in the amounts present, do not greatly affect the action of the dial-Ciba content. Solution dial-Ciba with urethane is proposed for intramuscular adminis- tration and, only when pressing emergency exists, for intravenous injection. The solution being strongly hypertonic, subcutaneous injection should never be employed. Solution Dial-Ciba with Urethane, Sterile Ampules, 2 cc: Each cubic centimeter contains dial-Ciba 0.1 Gm. (1^ grains), ethyl carbamate (urethane) 0.4 Gm. (6 grains), monoethylurea 0.4 Gm. (6 grains) and water q. s. Actions and Uses. — The same as those of dial-Ciba; it is claimed that the ethyl carbamate and monoethylurea are used as solvents, and, in the amounts present, do not greatly affect the action of the dial-Ciba content. Solution dial-Ciba with urethane is proposed for intramuscular adminis- tration and, only when pressing emergency exists, for intravenous injection. The solution being strongly hypertonic, subcutaneous injections should never be employed. Tablets Dial-Ciba, 0.1 Gm. (VA grains). Dial-Ciba occurs as a fine, white, crystalline powder, with a slightly bitter taste; completely soluble in alcohol and ether; very slightly soluble in cold water; insoluble in the paraffin hydrocarbons. A satu- rated aqueous solution is acid to litmus paper. Dial-Ciba melts at 171-173 C. Place approximately 0.3 Gm. dial-Ciba in a 25 cc. glass stoppered cylinder, add a mixture of 1 cc. normal sodium hydroxide solution and 5 cc. of water, shake the contents for one minute, filter through paper and divide into two portions; to one portion add 1 cc. of mer- curic chloride solution: a white precipitate results, soluble in 10 cc. of ammonia water; to the other portion add 5 cc. of silver nitrate solu- tion : a white precipitate results, soluble in 5 cc. of ammonia water. Boil 0.5 Gm. with 5 cc. of a 25 per cent sodium hydroxide solution: it is decomposed with the evolution of ammonia. Dissolve 0.1 Gm. in 1 cc. of sulfuric acid: the liquid assumes a yellow color, changing slowly to a brownish-red, finally to a dark red. Place 1 Gm. in a 25 cc. glass stoppered cylinder, add 10 cc. of water, shake for one rninute, filter through paper and divide into two portions; to one por- tion add 0.5 cc. of a saturated bromine water: an immediate discolora- tion occurs; to the other portion add 0.1 cc. of tenth-normal potassium permanganate: a yellow color appears immediately. Boil 0.5 Gm. of dial-Ciba with SO cc. of water for two minutes: no odor develops; cool and filter: separate portions of 10 cc. each of the filtrate yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution (chloride); no turbidity with 1 cc. of diluted BARBITAL COMPOUNDS 105 nitric acid and 1 cc. of barium nitrate solution (sulfate); no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Incinerate about 1 Gm. of dial-Ciba, accurately weighed: the residue does not exceed 0.1 per cent. Dissolve about 0.5 Gm., accurately weighed, in 25 cc. of previously neutralised alcohol; dilute with an equal volume of water and titrate with tenth-normal sodium hydroxide solution, using thymolphthalein as an indicator: the amount of tenth- normal sodium hydroxide solution consumed corresponds to not less than 98.5 per cent, nor more than 101.5 per cent of diallylbarbituric acid. IPRAL CALCIUM.— Calcium ethylisopropylbarbiturate.— Ca[(C2H5)(C3HT)CCONHCO: NCO]2-3H20. The calcium salt of ethylisopropylmalonyl urea. Actions and Uses. — Ipral calcium has the therapeutic proper- ties of barbituric acid. It is soluble in water and is absorbed promptly. It is claimed that it is excreted rapidly, but some action commonly persists for twenty-four hours. In therapeutic doses it affects the higher cerebral centers almost exclusively, and such doses exert no perceptible effect on the heart or cir- culation directly. Ipral calcium is used as a hypnotic to combat restlessness, irritability and sleeplessness. It is claimed that tolerance to ipral calcium is not developed readily, but that its action is so persistent that a patient frequently sleeps on the night succeed- ing that when the hypnotic was administered. Dosage. — From 0.12 to 0.25 Gm. (2 to 4 grains) followed by a cupful of hot water, tea or milk. Manufactured by E. R. Squibb & Sons, New York. U. S. patent 1,255,951 (Feb. 12, 1918; expired); 1,576,014 (March 9, 1926; expires 1943). U. S. trademark 208,813. Ipral Calcium Tablets, ^ grain. Ipral Calcium Tablets, 2 grains. Ipral calcium occurs as a white, crystalline, odorless powder, with a slightly bitter taste. It is soluble in about 40 parts of water at 25 C.; insoluble in alcohol. An aqueous solution is alkaline in reaction to litmus. Add. 0.2 Gm. to 20 cc. of water, acidify with 5 cc. diluted hydrochloric acid, filter, make filtrate ammoniacal, then add 2 cc. of ammonium oxalate solution: a precipitate forms, insoluble on addition of_ acetic acid in excess, but soluble on the addition of hydrochloric acid. Wash well the residue from the foregoing with water, dry at 100 C.: the melting point should be from 200 to 203 C. To 0.05 Gm. of residue add 2 cc. sodium hydroxide solution: the residue dissolves. Place 2 Gm. in a glass stoppered flask, treat with 25 cc. of carbon dioxide-free water and agitate occasionally over a period of two hours; by decantation separate the insoluble material, transfer the insoluble residue to a test tube, treat with diluted sulfuric acid and pass the emitted gases into 20 cc. of barium hydroxide solution : not more than a barely perceptible turbidity should result (limit of carbonate). Dry about 1 Gm., accurately weighed, to constant weight at 100 C.: the loss does not exceed 12 per cent. Transfer about 1 Gm., accurately weighed, to a glass stoppered cylinder, add 50 cc. of ether, stopper and shake the contents for five minutes; decant the supernatant liquid through filter paper and repeat, using 25 cc. and 15 cc. portions, respectively, of ether; evaporate the filtrate to dryness in a tared beaker and dry to constant weight at 100 C: the residue should not weigh more than 106 NEW AND NONOFFICIAL REMEDIES 4 per cent (limit of uncombined ethyliso propyl barbituric acid). Dis- solve about 1 Gm., accurately weighed, in water, acidify with 10 cc. of diluted hydrochloric acid, extract with five successive portions of ether, allow the solvent to evaporate spontaneously, dry the residue to constant weight at 100 C, and weigh: the weight of ethylisopropyl barbituric acid is not less than 78.5 per cent, nor more than 83.0 per cent. Ignite about 1 Gm., accurately weighed, cool, treat the residue with 5 cc. diluted hydrochloric acid, transfer to a 250 cc. beaker, add 25 cc. water and ammonia water until ammoniacal, warm, add 20 cc. boiling ammonium oxalate solution, boil and allow to stand over night; collect the precipitate on an ashless filter paper, wash with diluted ammonia water (1 part of ammonia water to 5 parts of water), transfer the precipitate to a platinum crucible, and ignite to constant weight: the weight of calcium oxide corresponds to not less than 8.0 per cent nor more than 8.5 per cent calcium. IPRAL SODIUM. — Sodium ethylisopropylbarbiturate. — Na(C2H5)(C3H0C-CONH-CO:NCO. The sodium salt of ethylisopropylmalonyl urea. Actions and Uses. — Ipral sodium has the therapeutic proper- ties of barbituric acid. It is soluble in water and is absorbed promptly. It is claimed that it is excreted rapidly, but some action commonly persists for twenty-four hours. In therapeutic doses it affects the higher cerebral centers almost exclusively, and such doses exert no perceptible effect on the heart or circulation directly. Ipral sodium is used as a hypnotic to combat restlessness, irritability and sleepnessness. It is claimed that tolerance to ipral sodium is not developed readily, and that its action is persistent. Dosage. — From 0.12 to 0.25 Gm. (2 to 4 grains) followed by a cupful of hot water, tea or milk. Manufactured by E. R. Squibb & Sons, New York. U. S. patents 1,255,951 (Feb. 12, 1918; expired); and 1,576,014 (March 9, 1926; expires 1943). U. S. trademark 208,813. Ipral Sodium Tablets, 4 grains. Ipral-Aminopyrine Tablets, 4.33 grains: Each tablet contains ipral (ethylisopropyl-barbituric acid) 2 grains, and aminopyrine 2.33 grains. Caution: Aqueous solutions of ipral sodium are not stable but decom- pose on standing; on boiling, a precipitation occurs. Ipral sodium is a white hydroscopic powder, soluble in water, slightly soluble in alcohol and practically insoluble in ether and chloroform. An aqueous solution of ipral sodium has an alkaline reaction to litmus. Dissolve about 0.5 Gm. of ipral sodium in 100 cc. of water, add an excess of diluted hydrochloric acid, collect the resultant ethylisopropyl barbituric acid on a filter, wash and dry at 100 C.: it melts at 200-205 C. Incinerate about 1 Gm. of ipral sodium: the residue responds to tests for sodium carbonate. Boil about 0.5 Gm. of ipral sodium with 5 cc. of a 25 per cent sodium hydroxide solution: it is decom- posed with evolution of ammonia. Dissolve about 0.3 Gm. of ipral sodium in 10 cc. of water and divide into two portions; to one por- tion add 1 cc. of mercuric chloride solution: a white precipitate results, soluble in an excess of ammonia; to the other portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in an excess of ammonia. BARBITAL COMPOUNDS 107 Dissolve about 0.5 Gm. of ipral sodium in 50 cc. of water, add 5 cc. of diluted nitric acid and filter through paper: separate portions of 10 cc. each of the filtrate yield no opalescence on the addition of 1 cc. of silver nitrate solution (chloride) ; no turbidity on the addi- tion of 1 cc. of barium nitrate solution (sulfate). To about 0.2 Grn. of ipral sodium in 25 cc. of water, add 1 cc. of diluted hydrochloric acid, filter through paper: the filtrate yields no coloration or precipi- tation on saturation with hydrogen sulfide (salts of heavy metals). Add about 0.1 Gm. of ipral sodium to 1 cc. of surf uric acid: the solution is colorless (readily carbonizahle substances). Transfer about 1 Gm. of ipral sodium, accurately weighed, to a glass stoppered cylinder, add 50 cc. of anhydrous ether, stopper and shake for ten minutes; decant the supernatant liquid through filter paper and repeat twice, using 25 cc. and 15 cc. portions, respec- tively, of ether, utilizing the same filter; evaporate the combined filtrates to dryness in a tared beaker and dry to constant weight at 90 C. : the residue does not exceed 0.2 per cent (uncombined ethylisopropyl barbituric acid). Dry about 1 Gm. of ipral sodium, accurately weighed, to constant weight at 100 C.: the loss does not exceed 2 per cent. Transfer about 0.5 Gm. of ipral sodium, accurately weighed, to a suitable Squibb separatory funnel, add 50 cc. of water, followed by addition of 10 cc. of diluted hydrochloric acid; extract with eight successive portions of ether of 25 cc. each, evaporate the combined ethereal extractions to dryness in a stream of warm air and dry to constant weight at 100 C. : the amount of ethylisopropyl barbituric acid cor- responds to not less than 88.5 per cent nor more than 90.5 per cent, calculated to the dried substance. Transfer the acidulated aqueous portion from the foregoing immiscible solvent extraction to a tared platinum dish and evaporate to dryness on a steam bath; to the residue obtained, add 5 cc. of sulfuric acid; heat cautiously until the excess of sulfuric acid has been volatilized; repeat twice, using por- tions of 1 cc. each of sulfuric acid each time; add about 0.5 Gm. of ammonium carbonate; ignite to constant weight, and weigh as sodium sulfate: the percentage of sodium corresponds to not less than 9.5 per cent nor more than 11.5 per cent when calculated to the dried substance. NEONAL. — n-Butylethylbarbituric acid. — «-Butylethyl- maloiiylurea. — 2,4.6-trioxv-5-H-Butylethylpyrimidin — (C4H9) (QHOC-CONHCONHCO. — Neonal differs from barbital- U. S. P. (diethylbarbituric acid) in that one of the ethyl groups of the former is replaced by a normal butyl group. Actions and Uses. — The actions and uses of neonal are essentially similar to those of barbital, but it is about three times as active as the latter ; hence it is used in correspond- ingly smaller doses. It is claimed that it exerts a sedative action to an exceptional degree, and that it is useful there- fore in high nervous tension, neuroses and other conditions in which a sedative is required. Dosage. — From 0.05 to 0.4 Gm. (^^ to 6 grains). For mild insomnias 0.05 to 0.1 Gm. (% to 1^ grains) is stated ordi- narily to produce sleep. A dose of 0.4 Gm. (6 grains) is the maximum dose which should be required in the course of twenty-four hours, administered in divided doses. Manufactured by the Abbott Laboratories, North Chicago, 111., under U. S. patent 1,609,520 (Dec. 7, 1926; expires 1943) by license of Les fitablissements Poulenc Freres. Paris. U. S. trademark 175,580. Neonal Tablets, 0.1 Gm. 108 NEW AND NONOFFICIAL REMEDIES Neonal occurs as a white, crystalline, odorless powder, with a slightly bitter taste; readily soluble in alcohol, about 1 in 5, and ether about 1 in 10; very slightly soluble in cold water; insoluble in the paraffin hydrocarbons. A saturated aqueous solution is acid to litmus paper. It melts at 124-127 C. It is stable in air. Place 0.3 Gm. in a 25 cc. glass stoppered cylinder, add a mixture of 1 cc. normal sodium hydroxide solution and 5 cc. of water, shake the contents for one minute, filter through paper and divide into two por- tions; to one portion add 1 cc. of mercuric chloride solution: a white precipitate results, soluble in 10 cc. of ammonia water; to the other portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in 5 cc. of ammonia water. Boil 0.5 Gm. with 5 cc. of a 25 per cent sodium hydroxide solution: it is decomposed with the evolution of ammonia. Dissolve 0.1 Gm. in 1 cc. of sulfuric acid: the solution is colorless (readily carhcmizable substances). Boil 0.5 Gm. with SO cc. water for two minutes: no odor develops; cool and filter: separate portions of 10 cc. each of the filtrate yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution (chloride) , no turbidity with 1 cc. of diluted nitric acid and 1 cc. of barium nitrate solution (sulfate); no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Incinerate about 1 Gm., accurately weighed: the residue does not exceed 0.1 per cent. Dissolve about 0.5 Gm., accurately weighed, in 25 cc. of previously neutralized alcohol, dilute with an equal volume of water and titrate with tenth-normal sodium hydroxide solution, using thymolphthalein as an indicator: the amount of tenth-normal sodium hydroxide solution consumed corresponds to not less than 98.5 per cent nor more than 101.5 per cent of butylethylbarbituric acid. NOSTAL. — Isopropyl bromallyl barbituric acid. — 5-iso- propyl-5-i3-bromallyl barbituric acid. — (C3H7) [CHoCBr : CH2] C-CONH-CONHCO.— Nostal differs from barbital-U. S. P. (diethylbarbituric acid) in that both of the ethyl groups of the former have been replaced, one by an isopropyl group and the other by a substituted brominated allyl group. Actions and Uses. — The actions and uses of nostal are essen- tially similar to those of barbital, but nostal is more active than barbital and is used in correspondingly smaller doses. Frac- tional doses are used as a sedative and larger doses as an hypnotic. Therapeutic doses act on the higher centers of the brain and are claimed not to exert any apparent injurious effect on the heart, circulation or kidneys. Dosage. — As a sedative: 0.05 to 0.1 Gm. (^ to 1^ grains). As an hypnotic: 0.1 to 0.3 Gm. (1^ to 4>^ grains); for chil- dren, 0.05 to 0.1 Gm. (% to 1^^ grains) according to age. Nostal should be administered preferably with a hot drink. Manufactured by J. D. Riedel-E. de Haen, A. G. Berlin, Germany (Riedel-de Haen, Inc., New York, distributor). U. S. patent 1,622,129 (March 22, 1927; expires 1944). U. S. trademark 270,750. Nostal Tablets, 0.1 Gm. ^i^ grains). Nostal occurs as a colorless, .crystalline, odorless powder, with a slightly bitter taste; readily soluble in alcohol, glacial acetic acid and acetone; sparingy soluble in ether, chloroform, benzene and water. A saturated aqueous solution is acid to litmus paper. Nostal melts at 177-179 C. BARBITAL COMPOUNDS 109 Fuse about 0.1 Gm. of nostal and 1 Gm. of crushed potassium hydroxide previously moistened with 1 cc. of alcohol in a nickel crucible: it is decomposed with the evolution of ammonia; cool, dis- solve the residue in 10 cc. of water, add 10 cc. of diluted nitric acid, filter through paper; to the filtrate add 5 cc. of silver nitrate solution: a cftrdy, dirty white precipitate results, soluble in a large excess of stronger ammonia water. Place approximately 0.3 Gm. of nostal in a 25 cc. glass stoppered cylinder, add a mixture of 1 cc. normal sodium hydroxide solution and 5 cc. of water, shake the contents for one minute, filter through paper and divide into two portions; to one portion add 1 cc. of mercuric chloride solution: a white precipitate results, soluble in 10 cc. of ammonia water; to the other portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in 5 cc. of ammonia water. Boil about 0.5 Gm. of nostal with 50 cc. of water for two minutes: no odor develops; cool and filter: separate portions of 10 cc. each of the filtrate yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution (soluble halides); no turbidity with 1 cc. of diluted nitric acid and 1 cc. of barium nitrate solution (sulfate); no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Incinerate about 1 Gm. of nostal, accurately weighed: the residue does not exceed 0.1 per cent. Dissolve about 0.5 Gm., accurately weighed, in 25 cc. of previously neutralized alcohol, dilute with an equal volume of water and titrate with tenth-normal sodium hydroxide solution, using thymolphthalein as an indicator: the amount of tenth- normal sodium hydroxide solution consumed corresponds to not less than 98.5 per cent, nor more than 101.5 per cent, 5-isopropyl-5-(fl) bromallyl-barbituric acid. Transfer about 0.25 Gm., accurately weighed, to a bomb tube; determine the bromine content by the Carius method: the amount of bromine found should be not less than 27.5 per cent, nor more than 27.9 per cent. ORTAL-SODIUM. — Sodium ?z-hexylethyl barbiturate.— Sodium ;z-hexylethyl malonylurea. — Na(CH3CH2CH2CH2CH2CH2)(aH5)CCONHc6:NCO. The monosodium salt of n-hexylethyl barbituric acid. Ortal-sodium differs from soluble barbital-U. S. P. (sodium diethylbarbitu- rate), in that one of the ethyl groups of the latter is replaced in the former by a w-hexyl group. Actions and Uses. — The actions and uses of ortal sodium are essentially similar to those of barbital, but ortal sodium is more active than barbital and it is used in correspondingly smaller doses. Dosage. — From 0.2 to 0.4 Gm. (3 to 6 grains) followed by a glass of water. It is rarely necessary to give more than 1 Gm. (15 grains) in twenty-four hours. When oral administration is contraindicated, ortal sodium may be administered rectally. Manufactured by Parke, Davis & Company. Detroit. U. S. patent 1,624,546 (April 12, 1927; expires 1944). U. S. trademark 302,616. Capsules Ortal Sodium, 54 grain (0.05 Gm.). Capsules Ortal Sodium, 3 grains (0.2 Gm.). Capsules Ortal Sodium, 5 grains (0.3 Gm.). Kapseals Ortal Sodium with Amidopyrine : Each kapseal (hermetically sealed capsule) contains ortal sodium lJ/$ grains (0.1 Gm.) and amido- pyrine 1^ grains (0.1 Gm.). 110 NEW AND NONOFFICIAL REMEDIES Kapseals Ortal Sodium with Phenacetin : Each kapseal (hermetically sealed capsule) contains ortal sodium IJ/^ grains (0.1 Gm.) and aceto- phenetidin (phenacetin) 3 grains (0.2 Gm.). Caution: Aqueous solutions of ortal-sodium are not stable but decom- pose on standing; on boiling, a precipitation ocurs with evolution of ammonia. Ortal-sodium is an odorless, white or slightly yellowish powder, with a bitter taste; very soluble in water; soluble in alcohol; practically insoluble in ether and benzine. An aqueous solution of ortal-sodium has an alkaline reaction to litmus. Dissolve about 0.5 Gm. of ortal-sodium in 100 cc. of water, add an excess of diluted hydrochloric acid, collect the resultant hexylethyl barbituric acid on a filter, wash and dry at 90 C.:_it melts at 122-125 C. Incinerate about 1 Gm. of ortal-sodium: the residue responds to tests for sodium carbonate. Boil about 0.5 Gm. of ortal-sodium with 5 cc. of a 25 per cent sodium hydroxide solution: it is decomposed with evolution of ammonia. Dissolve about 0.3 Gm. of ortal-sodium in 10 cc. of water and divide into two portions; to one portion add 1 cc. of mercuric chloride solution: a white precipitate results, soluble in an excess of ammonia; to the other portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in an excess of ammonia. Dissolve about 0.5 Gm. of ortal-sodium in 50 cc. of water, add 5 cc. of diluted nitric acid and filter through paper: separate portions of 10 cc. each of the filtrate yield no greater opalescence on the addition of 1 cc. of silver nitrate solution than that produced by 0.25 cc. of tenth-normal hydrochloric acid in 50 cc. of water (chloride); no tur- bidity on the addition of 1 cc. of barium nitrate solution (sulfate). To about 0.2 Gm. of ortal-sodium in 25 cc. of water, add 1 cc. of diluted hydrochloric acid, filter through paper: the filtrate yields no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Add about 0.1 Gm. of ortal-sodium to 1 cc. of sul- furic acid: the solution is colorless (readily carbonizable substances). Transfer about 1 Gm. of ortal-sodium, accurately weighed, to a glass stoppered cylinder, add 50 cc. of anhydrous ether, stopper and shake for ten minutes; decant the supernatant liquid through filter paper and repeat twice, using 25 cc. and 15 cc. portions, respectively, of ether, utilizing the same filter; evaporate the combined filtrates to dryness in a tared beaker and dry to constant weight at 90 C.: the residue does not exceed 0.5 per cent (iincombined hexylethyl barbituric acid). Dry about 1 Gm. of ortal-sodium, accurately weighed, to constant weight at 100 C.: the loss does not exceed 2.5 per cent. Transfer about 0.5 Gm. of ortal-sodium accurately weighed, to a suitable Squibb separatory funnel, add 50 cc. of water, followed by 10 cc. of diluted hydrochloric acid; extract with eight successive portions of ether of 25 cc. each, evaporate the combined ethereal extractions to dryness in a stream of warm air and dry to constant weight at 90 C.r the amount of hexyl barbituric acid corresponds to not less than 90.8 per cent nor more than 91.6 per cent, calculated to the dried substance. Trans- fer the acidulated aqueous portion from the foregoing immiscible sol- vent extraction to a tared platinum dish and evaporate to dryness on a steam bath; to "the residue obtained add 5 cc. of sulfuric acid; hqat cautiously until the excess of sulfuric acid has been volatilized; repeat twice, using portions of 1 cc. each of sulfuric acid each time; add about 0.5 Gm. of ammonium carbonate; ignite to constant weight, and weigh as sodium sulfate: the percentage of sodium corresponds to not less than 8.5 per cent, nor more than 9 per cent when calculated to the dried substance. PENTOBARBITAL-SODIUM.— Sodium ethyl (1-methyl- butyl) barbiturate. — Sodium ethyl (methylpropyl carbinyl) bar- biturate. — NaCCsHs) [CH3CH.CH2(CH3)CH] CCONHCO : NCO. The I I BARBITAL COMPOUNDS 111 monosodium salt of ethyl- (1-methylbutyl) barbituric acid. Pentobarbital-sodium differs from soluble barbital, U. S. P. (sodium diethylbarbiturate), in that one of the ethyl groups of the latter is replaced in the former by a 1-methylbutyl group. Actions and Uses. — The actions and uses of pentobarbital- sodium are essentially similar to those of barbital, but it is effective in smaller doses. The action is of relatively brief duration, which may constitute an advantage, especially when relatively large doses are administered. It is used as a seda- tive, particularly prior to local, general or spinal anesthesia. It can be used safely for such purposes only by those who have had adequate experience and who are familiar with the litera- ture concerning such use. It may be administered by mouth or by rectum; it may be administered intravenously only in conditions in which oral administration is not feasible either because the patient is unconscious, as in cerebral hemorrhage, eclampsia or status epilepticus, or because he resists, as in delirium, or because a very prompt action is imperative, as in convulsions from local anesthetics : but great caution is neces- sary when this product is given by vein. Dosage. — Orally, as hypnotic, 0.1 Gm. (1^ grains) ; as pre- anesthetic sedative, 0.2 Gm. (3 grains). Rectally, for analgesia: for infants up to 1 year, 0.03 Gm. (^ grain), up to 3 years, 0.06 Gm. (1 grain) ; for adults, 0.32 to 0.38 Gm. (5 to 6 grains) dissolved in a few cubic centimeters of water. Caution: Aqueous solutions of pentobarbital-sodium are not stable but decompose on standing; on boiling, a precipitation occurs with evolution of ammonia. Pentobarbital-sodium occurs as a white, crystalline, odorless powder, with a slightly bitter taste; very soluble in water; freely soluble in alcohol; practically insoluble in ether. An aqueous solution of pentobarbital-sodium is alkaline to litmus. Dissolve about 0.5 Gm. of pentobarbital-sodium in 100 cc. of water, add an excess of diluted hydrochloric acid, collect the resultant ethyl (1-methylbutyl) barbituric acid on a filter, wash and dry at 90 C: it melts at 127-130 C. Incinerate about 1 Gm. of pentobarbital-sodium: the residue responds to tests for sodium carbonate. Boil about O.S Gm. of pentobarbital-sodium with 5 cc. of a 25 per cent sodium hydroxide solution : it is decomposed with evolution of ammonia. Dissolve about 0.3 Gm. of pentobarbital-sodium in 10 cc. of water and divide into two portions; to one portion add Ice. of mercuric chloride solution: a white precipitate results, soluble in an excess of ammonia; to the other portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in an excess of ammonia. Dissolve about 0.5 Gm. of pentobarbital-sodium in 50 cc. of water, add 5 cc. of diluted nitric acid and filter through paper: separate por- tions of 10 cc. each of the filtrate yield no opalescence on the addition of 1 cc. of silver nitrate solution (chloride) ; no turbidity on the addition of 1 cc. of barium nitrate solution (sulfate). To about 0.2 Gm. of pentobarbital-sodium in 25 cc. of water, add 1 cc. of diluted hydrochloric acid, filter through paper: the filtrate yields no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Add about 0.1 Gm. of pentobarbital-sodium to 1 cc. of sulfuric acid: the solution is colorless (readily carbonisable sub- stances). Transfer about 1 Gni. of pentobarbital-sodium, accurately weighed, to a glass stoppered cylinder, add 50 cc. of anhydrous ether, stopper and shake for ten minutes; decant the supernatant liquid 112 NEW AND NONOFFICIAL REMEDIES through filter paper and repeat twice, using 25 cc. and 15 cc. portions, respectively, of ether, utilizing the same filter; evaporate the combined filtrates to dryness in a tared beaker and dry to constant weight at 90 C. : the residue does not exceed 0.2 per cent (nncombined ethyl [l-methylbutyl] barbituric acid). Dry about 1 Gm. of pentobarbital-sodiura, accurately weighed, to constant weight at 90 C. : the loss does not exceed 2 per cent. Trans- fer about 0.5 Gm. of pentobarbital-sodium, accurately weighed, to a suitable Squibb separatory funnel, add SO cc. of water, followed by addition of 10 cc. of diluted hydrochloric acid: extract with eight suc- cessive portions of ether of 25 cc. each, evaporate the combined ethereal extractions to dryness in a stream of warm air and dry to constant weight at 90 C.: the amount of ethyl (1-methylbutyl) barbi- turic acid corresponds to not less than 90 per cent nor more than 91 per cent, calculated to the dried substance. Transfer the acidulated aqueous portion from the foregoing immiscible solvent extraction to a tared platinum dish and evaporate to dryness on a steam bath; to the residue obtained add 5 cc. of sulfuric acid; heat cautiously until the excess of sulfuric acid has been volatilized; repeated twice, using por- tions of 1 cc. each of sulfuric acid each time; add about 0.5 Gm. of ammonium carbonate; ignite to constant weight, and weigh as sodium sulfate: the per cent of sodium corresponds to not less than 8.9 per cent, nor more than 9.4 per cent when calculated to the dried substance. Pentobarbital-S odium-Lilly. — A brand of pentobarbital- sodium-N. N. R. Manufactured by Eli Lilly & Co., Indianapolis, Ind. Ampoules Pentobarbital Sodium-Lilly, 0.5 Gm. (JVi grains): Each ampule contains the stated amount of pentobarbital sodium and is accom- panied by a 10 cc. size ampule of distilled water. Pulvules Pentobarbital-SodiiimrLilly, lYz grains: Pentobarbital-sodium- N, N. R., 0.1 Gm. (1^ grains) and starch, 0.13 Gm. PERNOSTON. — Butyl-i3-bromallyl barbituric acid. — 5- (butyl-2)-5-/3-brompropenyl malonylurea. — [CH(CH3)CH2CH3] (CH.CBr : CH2) C-CONHCONHCO. Pernoston differs from I I barbital (diethylbarbituric acid) in that both of the ethyl groups of the latter are replaced, one by a (normal) secondary butyl group, and the other by a substituted brominated allyl group. Actions and Uses. — The actions and uses of pernoston are essentially similar to those of barbital, but pernoston is more active than barbital and is used in correspondingly smaller doses. It is promptly absorbed and is rapidly changed and destroyed within the body. It is used in combating insomnia due to emotional strain and nervous instability. In therapeutic doses it is said to produce no demonstrable toxic effects on the heart, lungs, blood vessels and kidneys ; it does not inter- fere with the physiologic activities of these organs. Dosage: One tablet (3 grains) given one-half hour before sleep is desired, preferably foUow^ed by a glass of warm milk or lemonade. For hypnosis in the presence of pain : one tablet given in conjunction with aminopyrine or acetylsalicylic acid. Manufactured by J. D. Riedel-E. de Haen, A. G. Berlin, Germany (Riedel-de Haen, Inc., New York, distributor). U. S. patent 1,739,662 (December 17, 1929, expires 1946). U. S. trademark 266,216. Pernoston Tablets, 3 grains. Pernoston occurs as a fine, white, crystalline powder, with a slightly bitter taste; completely soluble in alcohol and ether; very slightly BARBITAL COMPOUNDS 113 soluble in cold water; insoluble in the paraffin hydrocarl)ons. A saturated aqueous solution is acid to litmus paper. Pernoston melts at 130 to 133 C. Place approximately 1 Gm. of Pernoston in a 25 cc. glass stoppered cylinder, add 10 cc. of water and 1 cc. sodium hydroxide solution and shake for one minute, filter through paper and divide into two portions; to one portion add 1 cc. of mercury bichloride solution: a white precipitate results, soluble in 10 cc of ammonia water; to the other portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in 5 cc. of ammonia water. Fuse about 0.1 Gm. of pernoston and 1 Gm. of crushed potassium hydroxide, previously moistened with 1 cc. _ of alcoholic potassium hydroxide solution, in a nickel crucible: it is decomposed with the evolution of ammonia; cool, dissolve the residue in 10 cc. of water, add 10 cc. of diluted nitric acid, filter through paper; to the_ filtrate add 5 cc. of silver nitrate solution: a curdy dirty white precipitate results, soluble in excess of stronger ammonia water. Dissolve 0.1 Gm. of pernoston in 1 cc. of sulfuric acid: the liquid assumes a yellow color, changing slowly to a brownish red, finally to a dark red. Place 1 Gm. of pernoston in a 25 cc. glass stoppered cylinder, add 10 cc. of water, shake for one minute, filter through paper and divide into two portions; to one portion add 0.5 cc. of a saturated bromine water: an immediate discoloration occurs; to the other portion add 0.1 cc. of tenth-normal potassium permanganate: a yellow color appears immediately. Boil 0.5 Gm. of pernoston with 50 cc. of water for two minutes: no odor develops; cool and filter; separate portions of 10 cc. each of the filtrate yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution (chloride) ; no turbidity with 1 cc. of diluted nitric acid and 1 cc. of barium nitrate solution (sulfate); no colora- tion or precipitation on saturation with hydrogen sulfide (salts of heavy metals) . Incinerate about 1 Gm. of pernoston, accurately weighed: the residue does not exceed 0.1 per cent. Transfer about 0.25 Gm._ of pernoston, accurately weighed, to a bomb tube; determine the bromine content by the Carius method: the amount of bromine found should be not less than 26.1 per cent nor more than 26.6 per cent. Dissolve about 0.5 Gm. of pernoston, accurately weighed, in 25 cc. of previously neu- tralized alcohol; dilute with an equal volume of water and titrate with tenth-normal sodium hydroxide solution, using thymolnhthalein as an indicator; the amount of tenth-normal sodium hydroxide solution con- sumed corresponds to not less than 98. 5 per cent nor more than 101.5 per cent of sec. butyl-bromallyl barbituric acid. PHANODORN.— Cyclobarbital.— Cyclohexenyl ethyl bar- bituric acid. — Ai-cyclohexenyl ethyl malonyl-urea. — 2,4,6, trioxy-5-cyclo-hexenyl-ethyl-pyrimidin. — CH.CH.CH2CH2CH : C(C2H5)C-CONHCONH-CO. Phano- dorn differs from barbital-U. S. P. (diethyl-barbituric acid) in that one of the ethyl groups of barbital is replaced by a cyclo- hexenyl group. Actions and Uses. — The actions and uses of phanodorn resemble those of barbital. It is eliminated more rapidly than barbital ; hence the action is not so lasting. This is an advan- tage when it is used merely to put one to sleep and sleep will then continue without its further action. It is used mainly for its sedative action in nervous insomnia, neurasthenia, psychoses, and various types of insomnia. Dosage. — For the mildest type of simple insomnia, 0.1 Gm. (1^ grains) or % tablet. In intractable or obstinate insomnia, from 0.2 to 0.4 Gm. (3 to 6 grains) or one to two tablets. The 114 NEW AND NONOFFICIAL REMEDIES larger dose should not be repeated within less than twelve hours. The average dose is 0.2 Gm. (3 grains), or one tablet. Manufactured by Winthrop Chemical Company, Inc., New York. U. S. patent applied for. Phanodorn Tablets, 3 grains. Phanodorn occurs as a white, crystalline, odorless powder, with a bitter taste; readily soluble in alcohol, about 1 in 5, and ether, about 1 in 10; very slightly soluble in benzene and cold water. A saturated aqueous solution is acid to litmus paper. It melts at 171-174 C. Dissolve 0.1 Gm. in 1 cc. of sulfuric acid: the liquid assumes a yellow color, changing quickly to orange, and finally to red. Place 0.3 Gm. in a 25 cc. glass stoppered cylinder, add 1 cc. normal sodium hydroxide solution and 5 cc. water, shake the contents for one minute, filter through paper and divide into two portions: the solutions yield a white precipitate with 1 cc. of mercuric chloride solution, soluble in 5 cc. of ammonia water; the solution yields a white precipitate with 2 cc. of silver nitrate solution, soluble in 5 cc. of ammonia water. Boil 0.5 Gm. with 5 cc. of a 20 per cent sodium hydroxide solution: it is decomposed with the evolution of ammonia. Boil 0.5 Gm. with 50 cc. of water for two minutes; no odor develops; cool and filter: separate portions of 10 cc. each of the filtrate yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution (chloride) ; no turbidity with 1 cc. of diluted nitric acid and 1 cc. of barium nitrate solution (sulfate) ; no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Incinerate about 1 Gm. accurately weighed: there is not more than 0.01 per cent residue. Dissolve about 0.5 Gm., accurately weighed, in 25 cc. of previously neutralized alcohol, dilute with an equal volume of water and titrate with tenth-normal sodium hydroxide solution, using thymolphthalein as an indicator: the amount of tenth-normal sodium hydroxide solution con- sumed corresponds to not less than 98.5 per cent nor more than 101.5 per cent. PHENOBARBITAL. — Phenylethylmalonylurea.— Pheno- barbitone. — Phenylethylbarbituric acid. — For standards see the U. S. Pharmacopeia under Phenobarbitalum. Actions and Uses. — The introduction of the phenyl group increases the hypnotic and sedative action of phenobarbital over that of barbital. The toxicity appears to be increased in about the same ratio. The sleep may be preceded by a period of excitement. Moderately large therapeutic doses sometimes cause severe circulatory depression. The formation of a habit has been reported. Phenobarbital has a sedative action on respiration, lessen- ing the frequency of breathing. It kills by respiratory paralysis. It is eliminated by the kidneys, a certain portion being probably decomposed in the organism. No gastric disturbances have been observed. Phenobarbital is used as a useful hypnotic in nervous insomnia and conditions of excitement of the nervous system ; its chief use in this field is as a sedative and antispasmodic in the treatment of epilepsy, in which it lessens the frequency and severity of seizures. Its use as a sedative has also been proposed in chorea, neurasthenia, cardiac and gastric neuroses, climacteric disorders, dysmenorrhea, exophthalmic goiter, and BARBITAL COMPOUNDS 115 preoperative and postoperative cases ; but it should be remem- bered that the drug has no curative action in such conditions. Dosage. — From 0.015 to 0.2 Gm. (^ to 3 grains) increased if necessary to 0.6 Gm. (10 grains). The average dose is 0.1 Gm. (1^ grain). A maximum dose of 0.6 Gm. (10 grains) should not be exceeded. Phenobarbital Tablets, J4 grain. Prepared by the Abbott Laboratories, North Chicago, 111. Phenobarbital Tablets, Y2 grain. Prepared by the Abbott Laboratories, North Chicago, 111. Phenobarbital Tablets, 11/2 grains. Prepared by the Abbott Laboratories, North Chicago, 111. Phenobarbital. — A brand of phenobarbital-U. S. P. Manufactured by Cane & Ingram, Inc., New York. Phenobarbital-Merck. — A brand of phenobarbital-U. S. P. Manufactured by Merck & Co., Rahway, N. J. Luminal. — A brand of phenobarbital-U. S. P. Manufactured by Winthrop Chemical Company, Inc., New York. U. S. patent 1,025,872 (May 7, 1912; expired). U. S. trademark 87,327. Elixir of Luminal: Each 4 cc. (one fluidrachm) contains 0.0162 Gm. (J4 grain) in a menstruum containing alcohol 26 per cent. Luminal Capsules^ lYz grains. Luminal Tablets, J4 grain. Luminal Tablets, Y^. grain. Luminal Tablets, lYz "rains. PHENOBARBITAL SODIUM.— Soluble Phenobarbital, Soluble Phenobarbitone. — "When dried at 140°C. for six hours, contains not less than 90.4 per cent and not more than 91.4 per cent of Phenobarbital (Ci2Hu"03N2)." U. S. P. For standards see the U. S. Pharmacopeia under Phenobar- bitalum Solubile. Actions and Uses. — The same as those of phenobarbital. Dosage. — For hypodermic injection, phenobarbital sodium is used in the form of 20 per cent solution, prepared by dissolving the salt in boiled and cooled distilled water ; 2 cc. (30 minims) of the solution contains 0.4 Gm. (6 grains) of phenobarbital sodium. The dose of phenobarbital sodium is 10 per cent greater than that of phenobarbital. Phenobarbital sodium may be given hypodermically in doses of 0.1 to 0.3 Gm. (1^ to 5 grains). Caution: Aqueous solutions of phenobarbital sodium are not stable but decompose on standing; on boiling, a precipitation occurs. Luminal Sodium. — A brand of soluble phenobarbital-U. S. P. Manufactured by Winthrop Chemical Company, Inc., New York. U. S. patent 1,025,872 (May 7, 1912; expired). U. S. trademark 87,327. 116 NEW AND NONOFFICIAL REMEDIES Ampules Luminal Sodium Solution in Ethylene Glycol, 2 cc: Each cubic centimeter contains luminal sodium 2.5 grains, dissolved in ethylene glycol. The solution may be administered intramuscularly or subcu- taneously but not intravenously. Ampules Luminal-Sodium (Powder), 2 grains. Ampules Luminal-Sodium (Powder), 5 grains. Capsules Luminal-Sodium, 5 grains. Luminal-Sodium Tablets, J4 grain. Luminal-Sodium Tablets, Yz grain. Luminal Sodium Tablets, lYz grains. Phenobarbital Sodium-Abbott. — A brand of soluble pheno- barbital-U. S. P. Manufactured by the Abbott Laboratories, North Chicago, 111. No U. S. patent or trademark. Ampoules Phenobarbital Sodium (Powder) -Abbott, 0.13 Gm. (2 grains). Tablets Phenobarbital Sodium- Abbott, 0.1 Gm. HVa grains). Phenobarbital Sodium-Mallinckrodt. — A brand of soluble phenobarbital-U. S. P. Manufactured by the Mallinckrodt Chemical Works, St. Louis. No U. S. patent or trademark. Phenobarbital Sodium-Merck. — A brand of soluble pheno- barbital-U. S. P. Manufactured by Merck & Co., Inc., Rahway, N. J. No U. S. patent or trademark. Phenobarbital Sodium-Gane and Ingram. — A brand of soluble phenobarbital-U. S. P. Manufactured by Gane and Ingram, Inc., New York. No U. S. patent or trademark. Tablets Phenobarbital Sodium-Gane and Ingram, i^ grains. SANDOPTAL.— Isobutylallyl barbituric acid.— Isobutylallyl malonylurea. — 2,4,6-trioxy-5-isobutylallyl pyrimidin. — (C4H9) (C3H5)C-CONHCONHCO. Sandoptal differs from barbital- U. S. P. (diethylbarbituric acid) in that both of the ethyl groups of the latter are replaced, one by an uo-butyl group and the other by an allyl group. Actions and Uses. — The same as those of barbital and its therapeutically useful derivatives. Dosage. — For mild insomnia, 0.2 Gm. (3 grains) ; for use in obstinate cases of insomnia, 0.4 to 0.8 Gm. (6 to 12 grains). Manufactured by Sandoz Chemical Works, Basle, Switzerland (Sandoz Chemical Works, Inc., New York, N. Y., distributor). No U. S. patent. U. S. trademark applied for. Tablets Sandoptal, 0.2 Gm. Sandoptal occurs as a white, crystalline, odorless powder, with a slightly bitter taste; completely soluble in ethyl alcohol, acetone, chloro- form, ether, ethyl acetate and glacial acetic acid; slightly soluble in cold water; sparingly soluble in boiling water and petroleum ether; insoluble in the paraffin hydrocarbons. A saturated aqueous solution is acid to litmus paper. It melts at 138-139 C. It is stable in air. Place about 0.3 Gm. of sandoptal in a 25 cc. glass stoppered cylinder, add a mixture of 1 cc. normal sodium hydroxide solution and 5 cc. of water, shake the contents for one minute, filter through paper and BARBITAL COMPOUNDS 117 divide into two portions; to one portion add 1 cc. of mercuric chloride solution: a white precipitate results, soluble in 10 cc. of ammonia water; to the other portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in 5 cc. of ammonia water. Boil about 0.5 Gm. of sandoptal with 5 cc. of a 25 per cent sodium hydroxide solution: it is decomposed with the evolution of strongly alkaline vapors. Place about 1 Gm. of sandoptal in a 25 cc. glass stoppered cylinder, add 10 cc. of water, shake for one minute, filter through paper and divide into two portions; to one portion add 1 cc. of acetic acid and 0.5 of a saturated bromine water; an immediate discoloration occurs; to the other portion add 0.1 cc. of tenth-normal potassium permanganate solution: a yellow color appears immediately, turning to brown. Dissolve about 0.1 Gm. of sandoptal in 1 cc. of sulfuric acid: the solution is colorless (readily carhonizable substances). Boil about 0.5 Gm. of sandoptal with 50 cc. of water for two minutes: no odor develops; cool and filter: separate portions of 10 cc. each of the filtrate yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution (chloride); no turbidity with 1 cc. of diluted nitric acid and 1 cc. of barium nitrate solution (sulfate); no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Incinerate about 1 Gm. of sandoptal, accurately weighed: the residue does not exceed 0.1 per cent. Dissolve about 0.5 Gm. of sandoptal, accurately weighed, in 25 cc. of previously neutralized alcohol; dilute with an equal volume of water and titrate with tenth-normal sodium hydroxide solution, using thymol-phthalein as an indicator: the amount of tenth-normal sodium hydroxide solution consumed corresponds to not less than 98.5 per cent nor more than 101.5 per cent of uobutylallyl barbituric acid. SODIUM ALURATE.— Sodium allylisopropyl barbiturate. — Na(C3H5)(C3H7)CCONH-c6:NCO.— The monosodium salt of allyl isopropyl barbituric acid. Sodium alurate differs from soluble barbital U. S. P. (sodium diethylbarbiturate), in that both of the ethyl groups of the latter are replaced, one by an allyl group and the other by an isopropyl group. Actions and Uses. — The same as those for alurate. The soluble sodium salt is intended for oral or rectal administration, particularly as preanesthesia medication. Sodium alurate may also be used in other cases in which large individual doses are required. Dosage. — The average preoperative dose is 1 grain for each 15 pounds of body weight (10 mg. per kilogram). One third of the calculated dose is given ten or twelve hours prior to operation, (usually the evening before) ; the remainder, two hours before operation. Experience is necessary in the use of these large dosages, as the amount of the drug must be adjusted to the individual patient in order to avoid undesirable reactions. Manufactured by Hoffmann-La Roche, Inc., Nutley, N. J. U. S. patent 1,444,802 (Feb. 13, 1923; expires 1940). U. S. trademark 230,059. Capsules Sodium Alurate, 31/2 grains: The content of each capsule is equivalent in potency to approximately 3 grains of alurate. Sodium alurate is a white microcrystalline, hydroscopic, odorless powder, with a slightly bitter taste; very soluble in water; very slightly soluble in alcohol; practically insoluble in ether. An aqueous solution of sodium alurate is alkaline to litmus. 118 NEW AND NONOFFICIAL REMEDIES Dissolve about 0.5 Gm. of sodium alurate in 100 cc. of water, add an excess of diluted hydrochloric acid; collect the resultant allyl isopropyl barbituric acid on a filter, wash and dry at 90 C: it melts at 139 to 140 C. Incinerate about 1 Gm. of sodium alurate: the residue responds to tests for sodium carbonate. Boil about 0.5 Gm. of sodium alurate with 5 cc. of a 25 per cent sodium hydroxide solution: it is decomposed with the evolution of ammonia. Dissolve about 0.3 Gm. of sodium alurate in 10 cc. of water and divide into two portions; to one portion add 1 cc. of mercuric chloride solution: a white precipitate results, soluble in an excess of ammonia water; to the other portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in an excess of ammonia water. Dissolve about 0.5 Gm. of sodium alurate in 50 cc. of water, add 5 cc. of diluted nitric acid and filter through paper: separate portions of 10 cc. each of the filtrate yield no opalescence on the addition of 1 cc. of silver nitrate solution (chloride) ; no turbidity on the addition of 1 cc. of barium nitrate solution (sjilfate). To about 0.2 Gm. of sodium alurate in 25 cc. of water, add 1 cc. of diluted hydrochloric acid, filter through paper: the filtrate yields no coloration or precipitation on satura- tion with hydrogen sulfide (salts of heavy metals). Add about 1 Gm. of sodium alurate to 1 cc. of sulfuric acid: the solution is colorless (readily carbonizable substance). Transfer about 1 Gm. of sodium alurate, accurately weighed, to a glass stoppered cylinder, add 50 cc. of anhydrous ether, stopper and shake for ten minutes; decant the supernatant liquid through filter paper and repeat twice, using 25 cc. and 15 cc. portions, respectively, of ether, utilizing the same filter; evaporate the combined filtrates to dryness in a tared beaker and dry to constant weight at 90 C.: the residue does not exceed 0.2 per cent (uncombined allylisopropyl barbituric acid). Dry about 1 Gm. of sodium alurate, accurately weighed, at 90 C. for forty-eight hours: the loss in weight should not be less than 4.5 per cent nor more than 7.5 per cent. Transfer about 0.5 Gm. of sodium alurate, accurately weighed, to a suitable Squibb separatory funnel, add 50 cc. of water, followed by addition of 10 cc. of diluted hydrochloric acid; extract with eight successive portions of ether of 25 cc. each, evaporate the combined ethereal extractions to dryness in a stream of warm air and dry to constant weight at 90 C. : the amount of allylisopropyl barbituric acid corresponds to not less than 90 per cent nor more than 91 per cent, calculated to the dried substance. Transfer the acidulated aqueous portion from the foregoing immiscible solvent extraction to a tared platinurn dish and evaporate to dryness on a steam bath; to the residue obtained add 5 cc. of sulfuric acid; heat cautiously until the excess of sulfuric acid has been volatilized; repeat twice, using portions of 1 cc. each of sulfuric acid each time; add about 0.5 Gm. of ammonium carbonate; ignite to constant weight, and weigh as sodium sulfate: the precentage of sodium corresponds to not less than 9 per cent nor more than 10 per cent when calculated to the dried substance. SODIUM AMYTAL.— Sodium Isoamylethylbarbiturate.— Ni(C5Hii)(C2H.0CCONHc6:NCO.— The monosodium salt of isoamylethylbarbituric acid. Sodium amytal differs from soluble barbital-U. S. P. (sodium diethylbarbiturate) in that one of the ethyl groups of the latter is replaced in the former by an isoamyl group. Actions and Uses. — The actions and uses of sodium amytal resemble those of barbital. The product is proposed as a sedative and hypnotic in the control of insomnia and as a preliminary to surgical anesthesia. Dosage. — As a potent sedative or hypnotic 0.2 Gm. (3 grains), repeated if necessary at intervals of six hours. For use before local or general anesthesia the dosage ranges between 0.2 and BARBITAL COMPOUNDS 119 0.6 Gm. (3 to 9 grains), being determined by a large number of factors (age, etc.). As an antispasmodic in tetanus, from 0.4 to 0.8 Gm. (6 to 12 grains) may be required to control con- vulsions. It can be used safely for such purposes only by those who have had much experience and are familiar with the litera- ture concerning such use. In some patients barbital derivatives produce restlessness and excitement, and to these patients sodium amytal should not be administered. It may be admin- istered by mouth, or, if necessary, the same dose may be given rectally, in the form of capsules inserted as suppositories or as powder placed in a little water ; it may be administered intravenously only in conditions in which oral administration is not feasible either because the patient is unconscious, as in cerebral hemorrhage, eclampsia or status epilepticus, or because he resists, as in delirium, or because a very prompt action is imperative, as in convulsions from local anesthetics : but great caution is necessary when this product is given by vein. Manufactured by Eli Lilly & Co.. Indianapolis, Ind. U. S. patent 1,514,573 (Nov. 4, 1924; expires 1941). U. S. trademark 161,125. Ampoule Sodium Amytal 0.065 Gm. (1 grain). Ampoule Sodium Amytal, 0.125 Gm. (17/$ grains). Ampoule Sodium Amytal, 0.25 Gm. (3^A grains): Each ampule con- tains the stated amount of sodium amytal and is accompanied by a 2.5 cc. size ampule of distilled water. Ampoules Sodium Amytal, 0.5 Gm. (lYi grains): Each ampule con- tains the stated amount of sodium amytal and is accompanied by a 5 cc. size ampule of distilled water. Ampoule Sodium Amytal, 1.0 Gm. (15 grains): Each ampule con- tains the stated amount of sodium amytal and is accompanied by a 10 cc. size ampule of distilled water. Pulvules Sodium Amytal, 1 grain. Pulvules Sodium Amytal, 3 grains. Sodium amytal occurs as a white, friable, hygroscopic odorless gran- ular powder with a slightly bitter taste; very soluble in water; freely soluble in alcohol about 1 part in 1 part; practically insoluble in ether. Dissolve about 0.5 Gm. of sodium amytal in 100 cc. of water, add an excess of diluted hydrochloric acid; collect the resultant isoamyl- ethylbarbituric acid on a filter, wash and dry: it melts at 152-155 C. Incinerate about 1 Gm. of sodium amytal: the residue responds to tests for sodium carbonate. Boil about 0.5 Gm. of sodium amytal with 5 cc. of a 25 per cent sodium hydroxide solution: it is decomposed with the evolution of ammonia. Dissolve about 0.3 Gm. of sodium amytal in 10 cc. of water and divide into two portions; to one portion add 1 cc. of mercuric chloridfe solution: a white precipitate results, soluble in an excess of ammonia; to the other portion add 5 cc. of silver nitrate solution: a white precipitate results, soluble in 5 cc. of ammonia water. Dissolve about 0.5 Gm. of sodium amytal in 50 cc. of water, add 5 cc. of diluted nitric acid and filter through paper: separate portions of 10 cc. each of the filtrate yield no opalescence on the addition of 1 cc. of silver nitrate solution (chloride); no turbidity on the addition of 1 cc. of barium nitrate solution (sulfate). To about 0.2 Gm. of sodium amytal in 25 cc. of water, add 1 cc. of diluted hydrochloric acid, filter through paper: the filtrate yields no coloration or precipita- tion on saturation with hydrogen sulfide (salts of heavy metals). Add about 0.2 Gm. of sodium amytal to 1 cc. of sulfuric acid: the solution is colorless (readily carbonizable substances). Transfer about 1 Gm. of sodium amytal, accurately weighed, to a glass stoppered cylinder, add 50 cc. of anhydrous ether, stopper and shake the contents for ten minutes; decant the supernatant liquid through filter paper, and repeat 120 NEW AND NONOFFICIAL REMEDIES twice, using first 25 cc. and second 15 cc. of ether and utilizing the same filter; evaporate the combined filtrate to dryness in a tared beaker and dry to constant weight at 100 C: the residue does not exceed 0.2 per cent (uncombined isoamyleihylbarbituric acid). Dry about 1 Gm. of sodium amytal, accurately weighed, to constant weight at 90 C. : The loss does not exceed 1 per cent. Transfer about 0.5 Gm. of sodium amytal, accurately weighed, to a suitable Squibb separatory funnel, add SO cc. of water, followed by the addition of 10 cc. of diluted hydrochloric acid, extract with eight successive por- tions of ether, using 25 cc. each, evaporate the combined ethereal extractions to dryness in a stream of warm air and dry to constant weight at 90 C.: The amount of isoamylethylbarbituric acid corresponds to not_ less than 90 per cent nor more than 91 per cent, calculated to the dried substance. Transfer the acidulated aqueous portion from the foregoing immiscible extraction to a tared platinum dish and evaporate to dryness on a steam bath; to the residue obtained add 5_cc. of sul- furic acid and heat cautiously until the excess of sulfuric acid has been volatilized; repeat twice, using 1 cc. of sulfuric acid each time, add about 0.5 Gm. of ammonium carbonate, ignite to constant weight and weigh as sodium sulfate: The percentage of sodium corresponds to not less than 8.9 per cent nor more than 9.5 per cent when calcu- lated to the dried substance. BARBITAL SODIUM. — Soluble Barbital. — Sodium Diethylbarbiturate. — Soluble Barbitone. — Sodium DiethA^mal- onyurea. — "It yields, when dried to constant weight at 100 C, not less than 88 per cent, and not more than 90 per cent of barbital (CsHi^OaNs)." U. S. P. For standards see the U. S. Pharmacopeia under Barbitalum Solubile. Actions and Uses. — The same as those of barbital. It is claimed, however, that this drug acts more rapidly on account of its greater solubility. Because of its solubility, administra- tion by rectal injection and also subcutaneous injection has been proposed. Dosage. — The same as that of barbital. It should be admin- istered in aqueous solution. Barbital Sodium-Abbott. — A brand of barbital sodium (soluble barbital) -U. S. P. Manufactured by Abbott Laboratories, North Chicago, 111. Barbital Sodium-Merck. — A brand of barbital sodium (soluble barbital)-U. S. P. Manufactured by Merck & Co., Rahway, N. J. Medina!. — A brand of barbital sodium (soluble barbital) - U. S. P. Manufactured by Schering & Glatz, Inc., New York. U. S. patent 780,241 (Jan. 17, 1905; expired) and 879,499 (Feb. 18, 1908; expired). U. S. trademark 269,753. Medinal Tablets, 5 grs. Medinal Suppositories, 10 grs. Veronal-Sodium. — A brand of barbital sodium (soluble bar- bital) -U. S. P. Manufactured by Winthrop Chemical Company, Inc., New York. U. S. patent 782,739 (Feb. 14, 1905; expired). U. S. trademark 40,115. Veronal-Sodium Tablets, 5 grains. BARIUM SULFATE 121 BARIUM SULFATE.— For standards see the U. S. Phar- macopeia under Barii Sulfas. Actions, Uses and Dosage. — Barium sulfate for roentgen examination, being freed from soluble barium and other salts, passes through the system unchanged and because of this is used in taking roentgenograms of the stomach and of the intestines. For Roentgen Examination of the Stomach. — The evening before the examination, the patient receives 1 fluidounce of castor oil. In the morning an ordinary portion of wheat-meal porridge, with which 2 ounces of barium sulfate has been well mixed, together with a little sugar and cream, is administered by mouth. The patient is then directed to abstain from further food. The examination is made six hours later. For Roentgen Examination of the Colon. — An enema con- sisting of 16 ounces of mucilage of acacia, 3 pounds of condensed milk, and 8 ounces of barium sulfate is warmed to body tem- perature and injected into the rectum from a height of from 3 to 6 feet (90 to 180 cm.). The examination is made with a fluoroscope while the injection is passing into the rectum. Skiabaryt for Oral Administration: A mixture of barium sulfate U. S. P., 75 to 85 per cent, admixed with sugar, tragacanth, vanillin cinnamon and cacao. Dosage. — Triturate 150 to 200 Gm. (5 to 6.5 ounces) with cold water added gradually to form a smooth, thin paste; then add warm water gradually until the mixture measures 500 cc. (16 fluidounces). The mixture is then ready for drinking. Merck & Co., Inc., New York, distributor. No U. S. patent. U. S. trademark 165,022. Skiabaryt for Rectal Administration: A mixture of barium sulfate U. S. P., 75 to 85 per cent, admixed with sugar, tragacanth, vanillin and cinnamon. Dosage. — Mix 200 Gm. (6.5 ounces) with cold water to form a smooth paste; then add warm water with stirring until the mixture has acquired a fairly fluid consistency. It is then ready for administration through the irrigator. Merck & Co., Inc., Rahway, N. J., distributor. No U. S. patent. U. S. trademark 165,022. Barium Sulphate Pure-Mallinckrodt. — A brand of barium sulphate-U. S. P. Manufactured by Mallinckrodt Chemical Works, St. Louis. Barium Sulphate-Merck for X-Ray Diagnosis. — A brand of barium sulphate-U. S. P. Manufactured by Merck & Co., Rahway, N. J. Barium Sulphate-Squibb for Roentgen-Ray Work. — A brand of barium sulphate-U. S. P. Manufactured by E. R. Squibb & Sons, New York. 122 NEW AND NONOFFICIAL REMEDIES BENZENE, MEDICINAL.— Benzenum Medicinale.— Medicinal Benzol. — Crystallizable Benzol. — CeHe. — A liquid consisting almost entirely of benzene (cyclohexatriene). Actions and Uses. — When swallowed, this drug usually pro- duces a sensation of burning in the stomach. Benzene is a narcotic which, when swallowed or inhaled, produces vertigo, dehrium and tonic convulsions followed by deep sleep ; the ingestion of 30 cc. (1 ounce) of nearly pure benzene has proved fatal. In some cases of chronic poisoning, petechial spots, due to small hemorrhages, have been observed. These spots have been attributed to fatty degeneration of the blood vessels. It produces leukocytosis followed by leukopenia with an occasional increased number of erythrocytes. Larger doses may produce an aplastic anemia. It has been stated that the aplastic anemia is due to a contamination of the drug with nitrobenzene or aniline. Benzene has been used occa- sionally on account of its narcotic properties and has also been used as an intestinal antiseptic. It is, however, rarely used for these purposes at the present time. It has been somewhat extensively used in the treatment of leukemia. Moderate doses cause a rapid destruction of the leukocytes, especially the lymphocytes. This action is accompanied by an improve- ment in the subjective symptoms and, in some cases, by a marked reduction in the size of the spleen. In many cases the lymphocytes have been reduced to the normal figure. In others the number of leukocytes has still remained high, although the size of the spleen was reduced. In many cases the improve- ment is such that an apparent cure is produced. However, a large number, if not all, of these patients relapse or succumb to the toxic action of the benzene. The administration of this drug should be stopped before the leukocytes are reduced to the normal level. Benzene has also been used in a few cases of Hodgkin's disease and in cases of polycythemia. The effect of benzene on the leukocytes is largely enhanced by the previous or simultaneous treatment with the roentgen rays. The value of benzene in leukemia is not established and caution against too large and too long-continued dosage should govern its employment. Dosage. — From 0.5 to 1 cc. (8 to 15 minims) given four times a day. Medicinal benzene may be given in capsules or in an emulsion or may be administered by rectum. Frequent examinations of the blood should be made during the admin- istration of medicinal benzene to determine when it is advisable to suspend the administration of the medicine. Medicinal benzene is prepared by fractional distillation of the light oil of coal tar and is a colorless, mobile liquid, possessing a strong characteristic, but not disagreeable, odor and a burning taste. It has a specific gravity of from 0.881 to 0.885 at 15 C. Medicinal benzene is insoluble in water but soluble in 90 per cent alcohol and in carbon disulfide; it is miscible with absolute alcohol and ether. BILE SALT COMPOUNDS 123 Medicinal benzene boils at from 79 to 82 C. It is inflammable and burns with a luminous and sooty flame. When cooled to C, medic- inal benzene solidifies. If cooled slowly it crystallizes in rhombohedral prisms, vyhich melt at about 6 C. It is neutral to litmus. Medicinal benzene is not affected by cold sulfuric acid, but is soluble in fuming nitric acid, without liberating nitrous vapors. When poured into water the mixture separates and deposits oily globules of nitrobenzene, which can be identfied by the odor. If 2 cc. of medicinal benzene be shaken with 0.5 cc. concentrated sulfuric acid and 1 drop of fuming nitric acid, no green or blue tint should be produced. Benzene (Benzol)-Merck Reagent, Thiophene Free. — A brand of benzene, medicinal-N. N. R. Merck & Co., Inc., Rahway, N. J., distributor. No U. S. patent or trademark. BILE SALTS AND BILE SALT COMPOUNDS The bile of man and of several animals contains the sodium salts of conjugated cholic acids in varying proportions; in ox and human biles especially glycocholic acid, C28H43O6N, and taurocholic acid, C2CH43O7NS. Fresh ox bile is said to con- tain about 3 per cent each of sodium glycocholate and sodium taurocholate. Actions and Uses. — The bile salts constitute the main active principles of bile, and therefore share the actions and uses of the latter, perhaps with the advantage of more constant composition. When injected into the circulation, they cause severe nervous and cardiac depression, not observed vi^hen they are given by the mouth. They are generally credited with a slight antiseptic and laxative action, with enhancing the efficiency of the resinous hydragogue cathartics, and with emulsifying and hence favoring the absorption of fat. They stimulate the secretory activity of the liver, increasing both the fluids and solids of the bile. They have been used in obstructive jaundice, although the rationale is somewhat doubtful ; their use in biliary fistula is more reasonable, if the nutrition is noticeably affected. The sodium glycocholate and taurocholate may be separated in the following manner: Dry ox bile is treated with absolute alcohol and the tincture preciptated by ether in excess. Both salts are deposited and the glycocholate crystallizes on standing, the taurocholate remain- ing in amorphous form, resembling oil or resinous matter. If the deposit is dissolved in water, solution of lead acetate will throw down a lead glycocholate, while the addition of lead subacetate to the remainder will precipitate the taurocholate. Tests: All the bile acids respond to Pettenkoflfer's test. A small portion of the salt is dissolved in a little concentrated sulfuric acid in a small porcelain dish and warmed, care being taken that the temperature does not rise higher than from 60 to 70 C. A 10 per cent solution of cane sugar is then added drop by drop while the liquid is stirred with a glass rod. If compounds of cholic acid are present a beautiful red color will appear, which does not disappear at room temperature, but usually in the course of a day becomes bluish violet. The red liquid shows in the spectrum two absorption bands, one at F and the other between D and E, nearer to E. Care must be taken not to heat too much or to add too much sugar. The sulfuric acid must be free from sulfurous acid and the lower oxides of nitrogen. As albumin, oleic acid, amyl alcohol, morphine, etc., may give a 124 NEW AND NONOFFICIAL REMEDIES similar reaction, spectroscopic examination should not be omitted in doubtful cases (Hammarsten: Lehrbuch der physiologischen Chemie, ed. 6, p. 312). Furfurol Test (Mylius) : The substance is dissolved in alcohol and for every cubic centimeter of the alcoholic solution, 1 drop of a 1 in 1000 furfurol solution and 1 cc. of concentrated sulfuric acid are added and the mixture cooled, if necessary, so that the tem- perature may not rise too high. The same color reaction occurs as in Pettenkoflfer's test. BILE SALTS-FAIRCHILD.— A preparation obtained from fresh ox bile, consisting essentially of sodium glycocholate and sodium taurocholate, in the proportion existing in ox bile. Actions and Uses. — See preceding general article, Bile Salts and Bile Salt Compounds. Dosage. — From 0.03 to 0.13 Gm. (^ to 2 grains). Manufactured by Fairchild Bros, and Foster, New York. No U. S. patent or trademark. DECHOLIN. — Dehydrocholic Acid. — An oxidation product of cholic acid derived from natural bile acids. Actions and Uses. — See preceding article, Bile Salts and Bile Salt Compounds. Decholin is proposed for use in functional insufficiency of the liver ; to outline the bile ducts at operation and in relieving the possible occurrence of some of the post- operative symptoms ; in cholecystography, to accelerate the appearance of the gallbladder shadow and to hasten removal of residual tetraiodophenolphthalein from the biliary apparatus ; in cardiac decompensation with hepatic congestions, cirrhosis of the liver and similar disturbances of hepatic function with ascites. Dosage. — From 0.25 to 0.5 Gm. (4 to 8 grains) two to three times daily after meals for a period of four to six weeks. Manufactured by J. D. Riedel-E. de Haen, A. G. Berlin, Germany ('Riedel-de Haen, Inc., New York, distributor). U. S. patent 1,933.003 (Oct. 21, 1933; expires 1950). U. S. trademark 315,067. Decholin Tablets, 3H grains. Decholin occurs as a fine, colorless, crystalline powder with a bitter taste: sparingly soluble in alcohol and glacial acetic acid. It melts at 233-235 C. Boil about 1 Gm. of decholin with 100 cc. of water for two minutes; no odor develops; cool and filter: Separate portions of 10 cc. each of the filtrate yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution (chloride); no turbidity with 1 cc. of diluted nitric acid and 1 cc. of barium nitrate solution (sulfate); no turbidity with 1 cc. of diluted sulfuric acid (soluble barium com- pounds); no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Dry about 1 Gm. of decholin, accurately weighed, at 100 C.: The loss in weight does not exceed 1.5 per cent. Incinerate about 1 Gm. of decholin, accurately weighed: the residue does not exceed 0.1 per cent Dissolve about 0.5 Gm., accurately weighed, in 40 cc. of previously neutralized alcohol, dilute with about one-half the volume of water and titrate with tenth-normal sodium hydroxide solution using phenol- phthalein as an indicator. The amount of tenth-normal sodium hydroxide solution consumed corresponds to not less than 98.5 per cent nor more than 101.5 per cent. BILE SALT COMPOUNDS 125 DECHOLIN SODIUM.— Sodium Dehydrocholate.— The sodium salt of dehydrocholic acid. Actions and Uses. — See preceding article, Bile Salts and Bile Salt Compounds. The actions and uses of decholin-sodium are the same as those of decholin. Dosage. — Decholin-sodium is administered intravenously. One injection is given on each of three successive days. According to the urgency of the case, the first dose consists of from 5 to 10 cc. of the 20 per cent solution; the second and third, of 10 cc. The 5 per cent solution may be used at the beginning or_ the end of the treatment or when a less intensive effect is desired. Manufactured by J. D. Riedel-E, de Haen, A. G. Berlin, Germany (Riedel-de Haen, Inc., New York, distributor). U. S. patent 1,933,003 (Oct. 31, 1933; expires 1950). U. S. trademark 315,083. Ampoules Solution Decholin-Sodium, 5 per cent, 10 cc. Ampoules Solution Decholin-Sodium, 20 per cent, 10 cc. Decholin-sodium occurs as a fine, colorless, crystalline powder with a very bitter taste, soluble in water and alcohol. An aqueous solution is alkaline to litmus. Dissolve about 1 Gm. of decholin-sodium in 200 cc. of water; add an excess of hydrochloric acid; collect the resultant dehydrocholic acid on a filter, wash, and recrystallize from 80 per cent acetic acid; it melts at 233-238 C. Dissolve about 0.5 Gm. of decholin-sodium in 100 cc. of water, acidify with hydrochloric acid and filter: Separate portions of 10 cc. each of the filtrate yield no turbidity with 1 cc. of barium chloride solution (sulfate) ; no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Dry about 1 Gm. of decholin-sodium accurately weighed, to constant weight at 100 C.: The loss in weight dose not exceed 7 per cent Weigh accurately about 1 Gm. in a tared platinum crucible, add 2 cc. of sulfuric acid, gently heat while fumes of sulfur trioxide are evolved, repeat, using two portions of 1 cc. of sulfuric acid, respectively, ignite, cool and weigh as sodium sulfate: The percentage of sodium corresponds to not less than 5.3 per cent, nor more than 5.6 per cent, when calcu- lated to the dried substance. GLYCOTAURO-H. W. & D.— Bile-Salts-H. W. & D.— Concentrated ox bile, freed from bile pigments, standardized to contain 50 per cent of the natural mixture of sodium glycocholate and sodium taurocholate. Each gram represents approximately 15 cc. of fresh ox bile. Actions and Uses. — See preceding general article, Bile Salts and Bile Salt Compounds. Manufactured by Hynson, Westcott & Dunning, Baltimore. No U. S. patent or trademark. Glycotaiiro-H. W. & D. Capsules, 5 grains. Glycotauro-H. W. & D. Capsules (half size): Each contains glycotauro 0.15 Gm. (2^ grains). Enteric Coated Glycotauro-H. W. & D. Tablets: Each contains gly- cotauro 2 grains (0.1 Gm.) and is coated with salol. Glycotauro is prepared by evaporating ox bile in the presence of animal charcoal, extracting the residue with purified methyl alcohol, filtering, evaporating the filtrate and mixing the residue with glycerin. Glycotauro is a soft semisolid mass of light brown color, bilelike odor and slightly bitter taste. It is easily soluble in water and alcohol. Its specific gravity is about 1.22. 126 NEW AND NONOFFICIAL REMEDIES BISMUTH COMPOUNDS The insoluble compounds of bismuth are used for their mechanical action as protectives of inflamed or irritated sur- faces. On a wound, a firm crust is formed, beneath which heal- ing proceeds. The drying property of the powder is of chief importance, and the antiseptic action secondary. For the best development of the protective mechanical action, a very fine division of the bismuth compound is essential. This has been secured in various ways. Soluble complex salts of bismuth, which are decomposed by dilute mineral acids with precipitation of insoluble bismuth salts in a very fine state of subdivision, are administered with the expectation that the gastric juice will bring about precipitation and thus protect the digestive tract. It is questionable whether this assumption is realized in many cases. Pharmacologists and many clinicians doubt the usefulness of all soluble bismuth preparations as a means of securing their protective action. On the other hand, the powder is given alone or prepared in a permanent suspension holding the bismuth in such a fine state of division as to favor its deposition evenly throughout the whole intestinal tract. Bismuth has been combined with other substances, either in mixture or in synthetic compounds, to produce insoluble com- pounds which shall be useful as a means of securing convenient administration or of enhancing protective and antiseptic actions. It is doubtful whether combination with antiseptic acids, as in bismuth subgallate or bismuth subsalicylate, increases the effici- ency of the preparation. The antiseptic acids lose their power in alkaline liquids, as in the intestines ; the introduction of iodine into the benzene nucleus does not increase the antiseptic power. On the other hand, bismuth compounds with phenol or with phenols in which bromine or iodine has replaced hydrogen in the benzene ring have an antiputrefactive action. Soluble compounds of bismuth used for their protective action should be employed with caution because of the danger of absorption of poisonous amounts of bismuth. Absorption of insoluble bismuth compounds from wounds and cavities occa- sionally occurs. Skin lesions similar to those sometimes fol- lowing the use of arsphenamine are among the most important complications of bismuth therapy. For example, a pruritus, an erythema, an urticaria or a dermatitis, and rarely hemorrhagic lesions, are noted following bismuth therapy ; and cases of agranulocytosis with angina have been reported. The adminis- tration of the drug should be stopped on the first sign of cuta- neous irritation. Bismuth poisoning is indicated by a blue line on the gums, headache, nausea and stomatitis. In some patients undergoing bismuth therapy systemic symptoms of malaise, headaches and vague rheumatic muscular and bone pains have been noted. Removal of the bismuth therapy is the principal treatment. Too free local application of bismuth-containing powders or too free injection into cavities should be avoided. BISMUTH COMPOUNDS 127 Large doses of bismuth subnitrate have produced nitrite poison- ing by its reduction in the colon. Alost of the bismuth compounds here described (excluding those for use in the treatment of syphilis) belong to the insoluble type. This includes bismuth betanaphtholate, bismuth tribromphenate, cremo-bismuth and lacbismo. In bismuth oxyiodogallate the bismuth is combined with an antiseptic acid which probably adds nothing to its antiseptic power ; on the other hand, bismuth betanaphtholate and bismuth tribrom- phenate are phenolic compounds which may reasonably be expected to have some antiseptic power. Until 1921 bismuth had been used particularly in the treat- ment of intestinal infections, as a paste for tuberculous fistulae and in radiology. Sauton and Robert then showed the value of sodium potassium bismuth tartrate in trypanosomiasis and spirillosis of fowls. Sazerac and Levaditi then took up the treatment of syphilis with the same drug. From this time on the value of bismuth preparations for treating syphilis has been more and more realized and its general use has been increased enormously throughout the world. For use in the treatment of syphilis, the administration of bismuth preparations by mouth has thus far not proved satisfac- tory nor has the value of bismuth inunctions been shown. The best results with bismuth therapy of syphilis have been achieved by intramuscular injections. Lomholt believes that roughly a bismuth salt to be efficacious in the treatment of syphilis should furnish at least 0.5 mg. metallic bismuth per kilo body weight. Most workers believe that the intravenous injections are strictly contra-indicated for the reason that the therapeutic dose approaches too closely to the toxic dose. The compounds employed for intramuscular injection consist of water soluble salts dissolved in aqueous solution or other suitable solvents, or suspended in oils ; of insoluble bismuth salts suspended in water or oils ; of so-called oil soluble preparations ; of water soluble and oil suspended combinations ; and finally of bismuth and arsenic compounds. The so-called oil soluble preparations are claimed to be more exact in their dosage than insoluble suspensions of bismuth salts. They are said not to be absorbed and excreted so rapidly as the soluble bismuth preparations. Yet the claim is made that they are absorbed more rapidly than the insoluble bismuth salts in suspension. Thus the claim is made that they combine some of the advantages of both the soluble and of the insoluble preparations. This question has not been entirely and satisfactorily answered as yet. Thus far it seems to be the generally accepted opinion that bismuth salts used in the treatment of syphilis should be administered by the intramuscular route. In giving the intra- muscular injections of the bismuth salts the needle should be inserted in the upper and the outer third of the buttocks, deep down into the muscular tissue; with the syringe tip inserted into the needle, the physician should aspirate back with the plunger of the syringe in order to be sure that the 128 NEW AND NONOFFICIAL REMEDIES needle is not in a vein or in an artery. This will go far toward obviating many of the distressing venous emboli and arterial emboli that have been reported. Those who have worked with bismuth salts in treating syphilis believe that their efficiency stands between that of mercury and that of arsphenamine. The present evidence appears to show that there is warrant for the administration of bismuth compounds in the treatment of syphilis in connection with arsphenamine and mercury or as a substitute for mercury therapy. Some few syphilologists use bismuth therapy alone in treatment of syphilis. These men are much in the minority, however, and time only will fully decide the value of this procedure. Thus far, sufficient evidence has not been produced to indicate the use of bis- muth preparations alone in the treatment of syphilis. Bismuth compounds are valuable in the treatment of syphilis in patients who are intolerant to other drugs or who show resistance to the other drugs used in syphilis by the persistence of a positive Wassermann reaction. Treatment with bismuth preparations is not usually injurious if the necessary precautions are taken (careful observation of the skin for untoward reaction, of the mouth for signs of beginning bismuth stomatitis and of the urine for evidence of irritation of the kidneys). Until the controversy concerning the penetration of appreciable amounts of special bismuth salts into the tissues of the central nervous system and of their presence in the spinal fluid is settled by more convincing evidence, it appears unwise to accept therapeutic implications based upon such claims. In common with another heavy metal, mercury, bismuth preparations, when administered by injection, have a definite diuretic action. Excretion studies of various bismuth com- pounds used in the treatment of syphilis give some indications as to the best type of bismuth salts for desired results. The usefulness of a bismuth preparation involves the concentration of active bismuth attained in the tissues, especially in the blood, and the height, course, rise, duration and decline of this concentration. As a rule, watery solutions, if repeated often enough, give a rapid and important absorption of the metal and high concentration in the blood stream. This can be kept up if the injections are given frequently enough, i. e., two or three times a week. Oil suspensions differ in that there is a slower absorption and concentration in the blood stream, but one which persists longer, thus requiring injections but once a week. Certain of the oil solutions have like characteristics, with an added more rapid absorption than the oil suspensions. Bismuth subsalicylate is much more slowly absorbed and there is a long delay before the bismuth effect is achieved. More- over, it continues to be excreted over long periods of time, even months. Whether this long excretion indicates a thera- peutic level of the drug in the body is doubtful. BISMUTH COMPOUNDS 129 BILIPOSOL. — A complex compound of high molecular weight, the chemical structure of which has not been established, combining bismuth and a-carboxethyl-/3-methyl nonoic acid. It contains about 45 per cent of bismuth. Actions and Uses. — Biliposol is proposed as a means of obtaining the systemic effects of bismuth in the treatrnent of syphilis (see preceding article, Bismuth Compounds). Biliposol belongs to the class of so-called liposoluble bismuth compounds which, because of their solubility, are absorbed with more rapidity than insoluble bismuth salts, approaching that of soluble bismuth salts, and which are not likely to cause abscess formation. Dosage. — For the average adult, doses of 2 cc. of biliposol solution (representing 0.04 Gm. of bismuth per cubic centimeter) are administered intramuscularly, in a series of twelve weekly injections. Treatment is discontinued for one month and then resumed by repeating the series of twelve injections. For infants and children the dosage ranges from 0.1 cc. to 0.6 cc, weekly. Manufactured by Laboratories Frangais de Chimiotherapie, Paris, France (Ulmer Laboratories, Minneapolis, distributor), U. S. patent applied for. U. S. trademark 269,486. Ampoules Biliposol Solution, 2 cc: A solution of biliposol in olive oil, containing 2 per cent of benzyl alcohol, L5 per cent of ethyl aminoben- zoate, and 1.5 per cent of butyl aminobenzoateper cubic centimeter. Each cubic centimeter of biliposol solution contains biliposol equivalent to 0.04 Gm. of bismuth (Bi). Biliposol occurs as a rather hard, stiff, unctuous, white or slightly yellowish mass having an odor; readily soluble in most organic sol- vents, including benzene, chloroform, ether, purified petroleum benzin and animal and vegetable oils. It softens when warmed. When sub- jected to very gentle ignition, it swells, setting free white fumes, and the mass darkens. Warm about 1 Gm. of biliposol with a slight excess of alcoholic potassium hydroxide, filter the insoluble portion and ignite .in a quartz dish: the residue is yellow. Evaporate the alcoholic filtrate: a yellowish residue remains; dissolve in 15 cc. of water and divide into three 5 cc. portions. Add 2 cc. of copper sulfate to 5 cc. of the solution, filter, wash with 5 cc. of water and dry: the residue is soluble in benzene. Add. 2 cc. of nickel chloride to another 5 cc. portion of the solution, filter, wash with 5 cc. of water and dry: the residue is soluble in benzene. Add. 2 cc. of cobalt nitrate to another 5 cc. por- tion of the solution, filter, wash with 5 cc. of water and dry; the residue is soluble in benzene. Ignite 2.8 Gm. of biliposol in a quartz crucible, cool, add cautiously drop by drop just sufficient nitric acid to dissolve the residue when it is warmed; pour the acid solution into 100 cc. of water, evaporate the filtrate on the water bath to 30 cc, again filter and divide the filtrate into 5 cc. portions; to one portion add an equal volume of diluted sulfuric acid: the liquid does not become cloudy (lead). To another portion add an excess of ammonia water: the supernatant liquid does not exhibit a bluish tint (copper). To another portion add diluted hydrochloric acid: a precipitate, insoluble in an excess of hydrochloric acid and soluble in ammonia water, is not formed (silver). Ignite 1 Gm. of biliposol in a quartz crucible: the residue meets the requirements of Bettendorf's test, U. S. P. X, p. 430 (arsenic). Transfer 0.2 Gm. to a separatory funnel, dissolve in 15 cc. of ether, extract with two 10 cc. portions of diluted nitric acid, add 1 cc. of barium chloride solution and sufficient water to make the volume 50 cc: after ten minutes there is no more turbidity than in a control tube containing the reagents used and 0.5 cc. of fiftieth normal sulfuric acid. Add. 1 cc. of silver nitrate solution to the remaining 10 cc. portion and 130 NEW AND NONOFFICIAL REMEDIES then add sufficient water to make the volume 50 cc. : after five minutes there is no more turbidity than in a control tube using the reagents and 0.5 cc. of fiftieth normal hydrochloric acid. Dissolve about 0.35 Gm. of biliposol, accurately weighed, in 25 cc. of chloroform, extract with one 20 cc. portion and two 10 cc. portions of diluted hydrochloric acid (one volume of "diluted hydrochloric acid- U. S. P." to one volume of distilled water), add filtered ammonia water a little at a time and with stirring until the precipitate that forms just dissolves. Saturate with hydrogen sulfide, filter, wash successively with water, alcohol, chloroform and ether, dry at 100 _C., cool in a desiccator, weigh: the bismuth sulfide weighed is equivalent to not less than 44.4 per cent nor more than 46.0 per cent of bismuth. Evaporate the chloroform solution to dryness on the steam bath and then dry to constant weight over calcium chloride: the weight cal- culated to a-carboxethyl-y8-methyl nonoic acid ion (multiply by 0.9958) is not less than 48 per cent nor more than 52 per cent. Add an excess of tenth-normal sodium hydroxide solution and titrate back with tenth- normal hydrochloric acid using phenolphthalein as an indicator, calcu- late to a-carboxethyl-;3-methyl nonoic acid ion (rnultiply the number of cubic centimeters of tenth-normal sodium hydroxide used by 0.024318) : the weight of acid ions is not less than 51 per cent nor more than 54.5 per cent (limit of dibasic acids) : Add an excess of sulfuric acid to the filtrate, evaporate and ignite in a weighed platinum dish: the weight of the residue, if any, should not exceed 0.5 per cent (alkali and alka- line earth metals). BISMO-CYMOL.— A basic bismuth salt of camphocar- boxylic acid (cainphor-3-carboxylic acid) having the probable formula (CioHi50COO)2BiOBi(CioHi50COO)OH. It contains between 37 and 40 per cent of bismuth. Actions and Uses. — Bismo-cymol is proposed as a means of obtaining the systemic effects of bismuth in the treatment of syphilis (see preceding article, Bismuth Compounds). Bismo- cymol belongs to the class of so called liposoluble bismuth com- pounds which, because of their solubility, are absorbed more rapidly than insoluble bismuth salts, approaching that of soluble bismuth salts. Though animal experiments seem to show a low toxicity for this preparation, in human beings it is well to watch the gums closely for evidence of beginning stomatitis. Dosage. — Bismo-cymol is injected intramuscularly in doses representing 0.1 Gm, of metallic bismuth once a week or in doses representing 0.05 Gm. of metallic bismuth twice a week for from six to eight weeks. Manufactured by Abbott Laboratories, North Chicago. U. S. patent applied for. U. S. trademark applied for. Bismo-Cymol Ampoules, 1 cc: Each ampule contains bismo-cymol equivalent to 0.05 Gm. of metallic bismuth, dissolved in olive oil. Bismo-Cymol Ampoules, 2 cc: Each ampule contains bismo-cymol equivalent to 0.1 Gm. of metallic bismuth, dissolved in olive oil. Bismo-cymol occurs as a white powder having the odor of camphor. It is insoluble in water but soluble in ether, benzene and vegetable oils. Heat 1 Gm. of bismo-cymol in 30 cc. of water containing 3 cc. of hydrochloric acid, add ammonia water until resulting solution is alka- line to litmus, filter and wash the precipitate with 7 cc. of water; to the filtrate add hydrochloric acid until just acid to litmus, evaporate on the steam bath until the volume is reduced one half, cool, filter and dry the crystals; the crystals melt at 127 C. Dissolve 0.1 Gm. of the crystals in 5 cc. of alcohol, add a drop of diluted ferric chloride solution (ferric chloride solution diluted 1 to 5); a green color BISMUTH COMPOUNDS 131 results. Dissolve the precipitate (obtained from the treatment with ammonia water) in diluted hydrochloric acid and pass in hydrogen sulfide; a black precipitate forms. Suspend 0.2 Gm. of bismo-cymol in 10 cc. of boiling water and add 2 Gm. of sodium hydrosulfite; a black precipitate forms. Add 5 cc. of sodium hydroxide solution and about 0.2 Gm. of aluminum wire to about 0.2 Gm. of bismo-cymol; heat gently: the vapors do not turn red litmus blue (nitrate). Suspend 0.25 Gm. in 30 cc. of water, add 4 cc. diluted nitric acid, boil, cool, filter and add 1 cc. of silver nitrate solution: no more turbidity is produced than in the U. S. P. test for chlorides using 0.1 cc. of fiftieth normal hydro- chloric acid (chloride). Suspend 0.1 Gm. in 30 cc. of water, add 4 cc. of diluted hydrochloric acid, boil, cool, filter, add 1 cc. of barium chloride solution and dilute to 50 cc: no turbidity is produced in ten minutes (sulfate). Add. 2 cc. of nitric acid to 2 Gm. of bismo-cymol in a porcelain crucible, evaporate to dryness on the steam bath, ignite, add 5 cc. of hydrochloric acid and 10 cc. of a saturated solution of stannous chloride in hydrochloric acid: the mixture does not darken in thirty minutes (arsenic). Ignite 3 Gm. of bismo-cymol in a quartz crucible, cool, add drop by drop just enough nitric acid to dissolve the residue when warmed, pour the acid solution into 100 cc. of distilled water, evaporate to 30 cc, filter if necessary and divide into 5 cc. portions. To one portion add an equal quantity of diluted sulfuric acid: the liquid does not become cloudy (lead). To another portion add an excess of ammoiiia water: the liquid does not exhibit a bluish tirit (copper). To another portion add 0.5 cc of diluted hydrochloric acid: a precipitate insoluble in an excess of hydrochloric acid and soluble in ammonia water is not formed (silver). Transfer about 0.2 Gm. of bismo-cymol, accurately weighed, to an Erienmeyer flask, add 1 Gm. of powdered potassium permanganate and then 5 cc of diluted sulfuric acid, allow to stand ten minutes, add 10 cc. of sulfuric acid in small portions, allow to stand fifteen minutes, decolorize with hydrogen peroxide, add 25 cc. of water, boil for fifteen minutes, pass in hydrogen sulfide until the bismuth i? completely precipitated, filter through a prepared gooch crucible, _ wash with water, alcohol, chloroform and ether in this order, dry in an oven for thirty minutes at 100 C., cool in a desiccator and weigh; repeat the washing with chloroform and ether and the drying at 100 C until constant weight is attained. The weight of bismuth sulfide corresponds to not less than 37 nor more than 40 per cent bismuth, BISMOSOL. — A sterilized solution of potassium sodium bismuthotartrate (containing 35 per cent bismuth [Bi] 10 Gm. ; piperazine, 0.3 Gm., in an aqueous solution of glucose, to make 100 cc. Actions and Uses. — Bismosol is proposed as a means of obtaining the systemic effects of bismuth in the treatment of syphilis (see preceding article, Bismuth Compounds). Dosage. — Bismosol is administered intramuscularly in doses of 1 cc. every two days until twenty doses have been given. After an intermission of one month, a second course may be given. Manufactured by Merck & Co., Inc., Rahway, N. J., by license of Les fitablissements Poulenc Freres, Paris. No U. S. patent. U. S. trade- mark 196,017. Bismosol Ampules, 1 cc. Bismosol is a pale yellow, syrupy liquid. On adding diluted hydro- chloric acid, drop by drop, to bismosol, a gelatinous precipitate is formed which redissolves on further addition of the acid; the resulting solution yields a brownish-black precipitate _ when saturated with hydrogen sulfide. _ On evaporation and ignition, bismosol yields an alkaline residue which effervesces with acids, 132 NEW AND NONOFFICIAL REMEDIES To 1 cc. of bismosol add three drops of acetic acid, a few drops of solution of hydrogen peroxide, one drop of ferrous sulfate solution and then an excess of sodium hj^droxide solution: a purple violet color is produced. To 1 cc. bismosol add diluted hydrochloric acid drop by drop, until the precipitate which is formed has redissolved, and then add a few cubic centimeters of potassium bismuth iodide solution: a brilliant red precipitate is produced. To S cc of bismosol add about 100 cc. water and sufficient hydro- chloric acid to redissolve the precipitate first formed; heat the solu- tion to from 70 to 80 C. and saturate with hydrogen sulfide to precipitate completely tne bismuth as bismuth sulfide. Collect the bismuth sulfide on a tared Gooch crucible, wash successively with water, alcohol, carbon disulfide and alcohol; dry to constant weight at 110 C. The weight of bismuth sulfide is equivalent to 3.5 Gm. of bismuth (Bi) in 100 cc. of bismosol. BISMUTH BETANAPHTHOL.— See the U. S. Pharma- copeia IX under Bismuthi Betanaphtholas. Bismuth Betanaphthol-Merck. — A brand of bismuth beta- naphthol. Manufactured by Merck & Co., Rahway, X. J. Orphol.--A brand of bismuth betanaphthol. Schering and Glatz, Inc., New York, distributor. No U. S. patent or trademark. BISMUTH SODIUM TARTRATE-SEARLE. — Bis- muth and Sodium Tartrate- Searle. — A basic sodium bismuth tartrate containing from 121 to 73.9 per cent of bismuth. Actions and Uses. — Bismuth sodium tartrate-Searle is pro- posed as a means of obtaining the systemic effects of bismuth in the treatment of syphihs (See preceding article, Bismuth Compounds). The drug has a definite diuretic action. Dosage. — 0.03 Gm. (^ grain) by intramuscular injection, preferably into the gluteal muscle. The initial dose is 0.015 Gm. (% grain), increased to 0.03 Gm. (1/2 grain) with the second dose and continued in three doses weekly for from six to ten weeks. Manufactured by G. D. Searle & Co., Chicago. U. S. patent 1,663,201 (March 20, 1928; expires 1945), and 1,801,433 (April 21, 1931; expires 1948). Ampoules Bismuth Sodium Tartrate-Searle, 1.5 per cent. 2 cc: Bismuth sodium tartrate-Searle, 0.03 Gm., benzyl alcohol 0.040 Gm., sucrose 0.50 Gm. in water sufficient to make 2 cc. Each ampule contains more than 2 cc. of solution. Ampoules Bismuth Sodium Tartrate-Searle, 3 per cent, 2 cc. — Bismuth Sodium Tartrate-Searle, 0.060 Gm.; benzyl alcohol, 0.040 Gm., and sucrose, 0.50 Gm., in distilled water to make 2 cc. Solution Bismuth Sodium Tartrate-Searle, 1.5 per cent, 60 cc. vial: An aqueous solution containing bismuth sodium tartrate-Searle 0.015 Gm., benzyl alcohol 0.02 Gm,, and sucrose 0.25 Gm., in one cubic centimeter. Solution Bismuth Sodium Tartrate-Searle, 3 per cent, 60 cc. vial. — An aqueous solution containing in each 2 cc. bismuth sodium tartrate- Searle, 0.060 Gm.; benzyl alcohol, 0.040 Gm., and sucrose, 0.50 Gm. Bismuth sodium tartrate-Searle is a finely divided, white powder, odorless and tasteless; permanent in air. The product is soluble in about three parts of water, except for a slight residue (0.1 per cent); the residue is soluble in sodium hydroxide solution. The aqueous solu- BISMUTH COMPOUNDS 133 tion is alkaline to litmus paper. When acid is added gradually to an aqueous solution of bismuth sodium tartrate-Searle a precipitate is pro- duced, which dissolves on the gradual addition of an alkali. Dissolve 0.5 Gm. of bismuth sodium tartrate-Searle in 25 cc. of water; heat to 50 C. ; add 1.5 Gm. of sodium hydrosulfite dissolved in 5 cc. of 10 per cent ammonia water: a precipitate of metallic bismuth forms. To about 2 cc. of the aqueous solution (10 per cent) add a few drops of copper sulfate solution. A blue precipitate is formed, which is soluble in potassium hydroxide solution. On standing, the alkaline solu- tion gradually deposits a precipitate. Ignite 3 Gm. in a quartz crucible, cool, and cautiously add drop by drop just sufficient nitric acid to dis- solve the residue when it is warmed; pour the acid solution into 100 cc. of water, evaporate the filtrate on the water bath to 30 cc, again filter and divide the filtrate into 5 cc. portions; to one portion add an equal volume of diluted sulfuric acid: the liquid does not become cloudy (lead). Add an excess of ammonia water to another portion: the super- natant liquid does not exhibit a bluish tint (copper). Add to another portion diluted hydrochloric acid: a precipitate, insoluble in an excess of hydrochloric acid and soluble in ammonia water, is not formed (silver). Ignite 1 Gm. in a quartz crucible: The residue meets the requirements of Bettendorf's test, U. S. P. X, p. 430 (arsenic). Dry about 1 Gm. of sodium bismuth tartrate-Searle, weighed accu- rately, at 100 C. to constant weight: the loss is from 2.6 to 3.6 per cent. Dissolve about 0.5 Gm. of bismuth sodium tartrate-Searle, accurately weighed, in 20 to 30 cc. of water and add sufficient hydrochloric acid to redissolve the precipitate first formed; saturate the solution with hydrogen sulfide; collect the precipitate of bismuth sulfide, wash it successively with water, alcohol, carbon disulfide, and ether and dry it at 100 C. : the weight of bismuth sulfide is equivalent to not less than 72.7 nor more than 73.9 per cent of bismuth (Bi). BISMUTH SUBNITRATE.— Basic Bismuth Nitrate— "A basic salt, which, when dried to constant weight over sulfuric acid, yields upon ignition not less than 79 per cent of Bi203."-[/. ^. P. For standards see the U. S. Pharmacopeia under Bismuthi Subnitras. Bismuth Paste Surgical-P. D. & Co.: Bismuth subnitrate, 1 part, in yellow petrolatum, 2 parts. Prepared by Parke, Davis & Co., Detroit. BISMUTH SUBSALICYLATE. — Basic Bismuth Sali- cylate. — "A basic salt, which, when dried to constant weight at 100°C., yields upon ignition not less than 62 per cent and not more than 66 per cent of Bi20.3."-L''. 6^. P. For standards see the U. S. Pharmacopeia under Bismuthi Subsalicylas, Bismuth Subsalicylate zvith Butyn-D. R. L. 60 cc. Bottle: A 10 per cent suspension of bismuth subsalicylate-U. S. P. in peanut oil to which has been added 0.4 per cent of butyn and metaphen 1 :20,000. Each cubic centimeter represents from 0.057 to 0.059 Gm. of elemental bismuth. Prepared by the Abbott Laboratories, North Chicago, 111. No U. S. patent or trademark. Ampoule Bismuth Subsalicylate with Butyn-D. R. L., 1 cc: A 10 per cent suspension of bismuth subsalicylate-U. S. P. in peanut oil to which has been added 0.4 per cent of butyn and metaphen 1: 20,000. Each cubic centimeter represents from 0.057 to 0.059 Gm. of elemental bismuth. Prepared by the Abbott Laboratories, North Chicago, 111. No U. S. patent or trademark. 134 NEW AND NONOFFICIAL REMEDIES Ampules Bismuth Subsalicylate 2 grains (0.13 Gm.) in Oil, 1 cc: A suspension of bismuth subsalicylate-U. S. P., 0.13 Gm., camphor 0.1 Gm., and creosote 0.1 Gm., in sufficient olive oil to make 1 cc. Prepared by the Cheplin Biological Laboratories, Inc., Syracuse, N. Y. No U. S. patent or trademark. Bismuth Salicylate in Oil-P. D. &r Co., 2 ounce bottle: A suspension of bismuth subsaUcylate-U. S. P., in olive _ oil, containing 3 per cent of chlorobutanol. Each cubic centimeter contains bismuth subsalicylate, 0.13 Gm. (2 grains). Prepared by Parke, Davis & Co., Detroit.' No U. S. patent or trade- mark. Glaseptic Ampules Bismuth Salicylate in Oil-P. D. & Co., 1 cc: Each ampule contains 1 cc. oi a suspension of bismuth subsalicylate-U. S. P.. 0.13 Gm. (2 grains), in olive oil, containing 3 per cent of chlorobutanol. Prepared by Parke, Davis & Co., Detroit. No U. S. patent or trade- mark. Bismuth Salicylate in Oil-U. S. S. P. Co.: A suspension of bismuth subsalicylate, U. S. P., 2 grains (0.13 Gra.) and chlorbutanol, 3 per cent, in neutral olive oil to make 1 cc. Marketed in bottles containing 1 ounce. Prepared by the United States Standard Products Company, Wood- worth, Wis. Bismuth Subsalicylate-Merck. — A brand of bismuth sub- salicylate-U. S. P. Manufactured by Merck & Co., Rahway, N. J. BISMUTH TRIBROMPHENATE.— Bismuthi Tri- bromphenas. — Bismuth Tribromphenol. — Xeroform. — A basic bismuth tribromphenate of variable composition. Actions and Uses. — Bismuth tribromphenate is claimed to be a nonirritant and nontoxic antiseptic. It is said to be useful as an odorless and efficient substitute for iodoform ; valuable in ulcus cruris and all weeping eczemas; internally, in gastro-intestinal catarrh, proctitis, dysentery, bacillary and choleraic diarrhea, cholera infantum, etc. Dosage. — From 1 to 3 Gm. (15 to 45 grains) per day to adults; from 0.125 to 0.3 Gm. (2 to 5 grains) at a dose to children. Externally (as a dusting powder, in bandages, etc.) like iodoform, in lotions, and in ointments. Bismuth tribromphenate is an amorphous, yellow, nearly odorless and tasteless powder, neutral to moistened litmus paper. It is only slightly soluble in water, alcohol, chloroform, liquid petrolatum and vegetable oils. Alkalis and strong acids decompose it. It is stable at temperatures below 120 C. Boil about 1 Gm. of the salt with 10 cc. of sodium hydroxide solu- tion, filter the liquid and acidulate the filtrate with sulfuric acid: the white curdy precipitate produced, when washed and dried, melts at from 90 to 95 C. (tribromphenol). The contents of the filter dis- solve completely in diluted hydrochloric acid (insoluble inert material). Boil 1 Gm. of bismuth tribromphenate with 20 cc. of a mixture of equal parts of acetic acid and water, cool the solution and filter. Free the filtrate from bismuth by saturating with hydrogen sulfide, boil the mixture and again filter: the latter filtrate leaves not more than 0.005 Gm. of residue on evaporation and gentle ignition (alkalis and alkali earths). Shake 2 Gm. of bismuth tribromphenate, 20 cc. of ether, and 20 cc. of a mixture of equal volumes of hydrochloric acid and distilled water in a separatory funnel for one or two minutes. Draw off the aqueous portion and concentrate to about 4 cc; pour it into 100 cc. of distilled water, filter, evaporate the filtrate on the water bath to 30 cc, again filter and divide this filtrate into portions of 5 cc. each. Mix one por- tion with an equal volume of diluted sulfuric acid: it does not become BISMUTH COMPOUNDS 135 cloudy (lead). Treat another portion with a slight excess of ammonia water: the supernatant liquid does not exhibit a bluish tint (copper); another portion is not immediately affected by barium nitrate test solution (sulfate). Heat gently a mixture of about 0.2 Gm. of bismuth tribromphenate with 5 cc. of notassium hydroxide solution and about 0.2 Gm. of aluminum wire: the vapors evolved do not turn red litmus blue (nitrates). Shake 1 Gm. of bismuth tribromphenate frequently during fifteen minutes with 30 cc. of alcohol (95 per cent), filter and rinse the flask with two separate 10 cc. portions of alcohol, allowing the washings to run through the filter. To the combined filtrate and washings add 5 cc. of tenth-normal sodium hydroxide, using a few drops of phenolphthalein solution as an indicator and determine the excess of alkali with tenth- normal hydrochloric acid; not more than 1 cc. of tenth-normal sodium hydroxide should have been consumed by the alcoholic liquid (free tribromphenol). Add 2 _ cc. of nitric acid to 2 Gm. of bismuth tribromphenate in a porcelain crucible, carefully evaporate to dryness on a sand bath and incinerate. Dissolve the residue in 5 cc. of concentrated hydro- chloric acid and add to the solution 10 cc. of a saturated solution of stannous chloride in concentrated hydrochloric acid: the mixture should not darken on standing thirty minutes (arsenic). Mix 0.5 Gm. of the salt with 10 cc. of a mixture of equal parts of hydrochloric acid and distilled water: no effervescence should occur (carbonate). To about 0.5 Gm. of bismuth tribromphenate, accurately weighed, add 20 cc. of hydrochloric acid and digest on a water bath. Add 150 cc. of water and filter. Rinse the beaker with 30 cc. of acidulated water and allow the washings to run through the filter. Saturate the com- bined filtrate and washings with hydrogen sulfide (care being exercised that the solution is not too acid so as to prevent quantitative precipi- tation of the bismuth sulfide), filter off the bismuth sulfide, wash and dissolve in hot dilute nitric acid. Add a slight excess of ammonia water followed by 2 cc. of ammonium carbonate test solution. Allow to stand thirty minutes, filter off the precipitated bismuth hydroxide and heat to constant weight at dull red heat: the residue of bismuth oxide (BizO.-i) should not be less than 45 per cent or more than 55 per cent of the original weight of bismuth tribromphenate taken, corresponding to not less than 40 per cent nor more than 49 ner cent of bismuth. Xeroform-S. and G. — A brand of bismuth tribromphenate- N. N. R. Marketed by Schering and Glatz, Inc., New York, N. Y. No U. S. patent or trademark. CREMO-BISMUTH.— Milk of Bismuth-S. & D.— A mix- ture consisting of bismuth subcarbonate, suspended in water in a finely divided state, each hundred cubic centimeters repre- senting the equivalent of 8.66 Gm. (40 grains in 1 fluidounce) of bismuth subnitrate. Dosage. — From 4 to 15 cc. (1 to 4 fluidrachms), every two or three hours. Prepared by Sharp & Dohme, Philadelphia and Baltimore. U. S. trade- mark 29,335. LAC BISMO. — Mistura Bismuthi-Hart.— A mixture said to consist of bismuth hydroxide and bismuth subcarbonate, suspended in water, in a finely divided state, and containing 0.15 Gm. {2y2 grains) of the salts in 4 cc. (1 fluidrachm). Dosage. — From 4 to 15 cc. (1 to 4 fluidrachms). Prepared by E. J. Hart & Co., Ltd., New Orleans. U. S. trademark. 136 NEW AND NONOFFICIAL REMEDIES MESUROL.—Benzobis.— Basic Bismuth Methoxy Hydroxy Benzoate. — A basic bismuth saU of methoxyhydroxybenzoic acid, of variable composition, containing from 54 to 57 per cent of bismuth. Actions and Uses. — Mesurol is proposed as a means of obtaining the systemic effects of bismuth in the treatment of syphilis. (See preceding article, Bismuth Compounds). Dosage. — Mesurol is administered intramuscularly in the form of emulsion mesurol, 20 per cent. The initial dose is 0.5 cc, increased to 1 cc. (0.103 to 0.117 Gm. of Bismuth) at the second dose and continued until from eight to twelve weekly doses have been administered. Manufactured by Winthrop Chemical Company. Inc., New York. U. S. patent, 1,522,054 (Jan. 6, 1925; expires 1942). U. S. trademark 226,373. Emulsion Mesurol, 20 per cent: A suspension of mesurol in sesame oil each cubic centimeter of which contains mesurol equivalent to from 0.103 to 0.117 Gm. of bismuth (Bi). Mesurol is a yellowish gray powder, insoluble in water and in most organic solvents. Suspend about 0.05 Gm. of mesurol in 5 cc. of water and add S cc. of ammonium sulfide: the solid blackens. Suspend 0.1 Gm. in 5 cc. of water, acidify with hydrochloric acid and allow to cool: crystals appear, which, on addition of ferric chloride solution, cause the formation of a deep blue color; the crystals, after drying, melt at 152 C. Agitate 1 Gm. of mesurol with 20 cc. of chloroform, filter the liquid and evaporate the filtrate to dryness: not more than 0.005 Gm. of residue remains (free methoxyhydroxybenzoic acid). Ignite 3 Gm. in a quartz crucible, cool, and cautiously add drop by drop just sufficient nitric acid to dissolve the residue when it is warmed; pour the acid solution into 100 cc. of distilled water, evaporate the filtrate on the water bath to 30 cc, again filter and divide the filtrate into 5 cc. por- tions; to one portion add an equal volume of diluted sulfuric acid: the liquid does not become cloudy (lead). Add an excess of ammonia water to another portion: the supernatant liquid does not exhibit a bluish tint {copper). Add to another portion diluted hydrochloric acid: a precipitate, insoluble in an excess of hydrochloric acid and soluble in ammonia water, is not formed {silver). Boil 1 Gm. in 70 cc. of water, add hydrochloric acid in small portions to the boiling suspension until the suspended particles dissolve, saturate with hydrogen sulfide and filter; evaporate the filtrate to a small bulk, cool, transfer to a platinum dish, add 2 cc. of sulfuric acid, evaporate to dryness and ignite: the residue weighs less than 0.005 Gm. {alkali or alkaline earth salts). Triturate about 0.05 Gm. with 0.1 Gm. of sodium salicylate and 5 cc. of distilled water, and superimpose the mixture on 5 cc. of sulfuric acid: no pink or brownish-red zone is observed at the line of contact {nitrate). Suspend 0.06 Gm. in boiling water, add diluted nitric acid in small portions until the suspended particles dissolve, cool, dilute to 50 cc. and add 1 cc. of silver nitrate solution: a precipitate is not formed {chloride). Transfer about 2 Gm. of mesurol, accurately weighed, to a quartz crucible; dry to constant weight at 100 C. : the loss in weight at 100 C. is not more than 1 per cent. Ignite the dried product and after cooling add 5 cc. of nitric acid drop by drop to the residue, warming until solution has been effected; evaporate to dryness, carefully ignite it at red heat, and weigh the resulting bismuth oxide : the residue corre- sponds to not less than 54 per cent nor more than 57 per cent of bis- muth. The residue meets the requirements of Bettendorf's test, U. S. P. X, page 430 {arsenic). BISMUTH COMPOUNDS 137 OLEO-BI-ROCHE.— A suspension of finely divided bis- muth oleate, Bi (Ci7H33COO)3, in olive oil, containing bismuth oleate equivalent to 0.05 Gm. of bismuth (Bi) in each cubic centimeter. Actions and Uses. — Oleo-Bi-Roche is proposed as a means of obtaining the systemic effects of bismuth in the treatment of syphilis (see preceding article, Bismuth Compounds). Dosage. — Two cc. intramuscularly, preferably into the glu- teal muscle, once a week ; in the case of adults, from twelve to twenty injections of 2 cc. are proposed as a course of treatment. The product is supplied in 25 cc. and 100 cc. bulk packages. Manufactured by F. Hoffmann-LaRoche and Co., Basle, Switzerland (Hoffmann-LaRoche, Inc., Nutley, N. J., distributor). U. S. patent 1,547,165 (July 28. 1925; expires 1942). U. S. trademark 183,191. In the manufacture of oleo-bi-Roche, moist bismuth oleate is emul- sified and dehydration takes places subsequently. The bismuth oleate used complies with the following standards: It is a soft, amorphous mass, insoluble in water; partially soluble in alcohol and ether. Its bismuth content is 19.8 per cent, and its oleic acid content about 77.8 per cent. Suspend about 1 Gm. of bismuth oleate in 10 cc. of ether. Shake the mixture with 10 cc. of diluted hydrochloric acid, draw off the aqueovis layer and cautiously pour diphenylamine solution over it: a blue zone does not appear (nitrate). Introduce about 1.5 Gm. of moist bismuth oleate (representing 0.1 to 0.3 Gm. of Bi), accurately weighed, into a beaker of 50 cc. capacity. Pour 20 cc. of ether over the bismuth oleate and stir with a glass rod. Transfer the turbid liquid to a separator and complete the transfer with three portions of ether of 5 cc. each. Add 5 cc. of nitric acid (25 per cent) to the contents of the separator and agitate the contents for one to two minutes. When separation has occurred, draw the aque- ous portion into a beaker. Extract the etheral liquid in a sepa- rator three times with 5 cc. portions of diluted nitric acid and add the washings to the contents of the beaker. Dilute the acid extrac- tions with water to make about 80 cc. Add a drop of methyl orange solution to the liquid and neutralize it with 10 per cent ammonium carbonate solution (cover the beaker with a watch glass to avoid loss by spattering) and then add a further quantity of 5 cc. of 10 per cent ammonium carbonate solution. Complete the determination in the usual way and weigh as bismuth oxide. Introduce about 1.5 Gm. of moist bismuth oleate into a 50 cc. beaker and weigh accurately. Add 20 cc. of ether and stir with a glass rod. Transfer the mixture to a 50 cc. separator and complete the transfer with three 5 cc. portions of ether. Add 5 cc. of 25 per cent nitric acid to the liquid in the separator and agitate the mixture. After separation, draw off the acid liquid and then extract the ether solution with three 5 cc. portions of 10 per cent nitric acid and finally with 5 cc. portions of water until the washings are neutral to litmus. Filter the ether solution into a small flask and complete the transfer with ether. Remove the ether in the flask by distillation, dissolve the residue in 30 cc. of neutral alcohol and determine the acidity of the solution by titration with tenth-normal sodium hydroxide, using phenol- phthalein as indicator. From the volume of tenth-normal alkali con- sumed, calculate the percentage of oleic acid. BISMUTH AND POTASSIUM TARTRATE.— Potas- sium Bismuth Tartrate. — Potassium Bismuthyl Tartrate. — "A basic bismuth potassium bismuthotartrate, containing the 138 NEW AND NONOFFICIAL REMEDIES equivalent of not less than 71 per cent and not more than 75 per cent of BisOs/'-t/. i'. P. For standards see the U. S. Pharmacopeia under Bismuthi et Potassii Tartras. Potassium Bismuth Tartrate-D. R. L. — A brand of potas- sium and bismuth tartrate-U. S. P. Dosage. — (a) Oily Suspension. — From 0.1 to 0.2 Gm. (1^^ to 3 grains) by intramuscular injection, preferably into the gluteal muscle. The injections may be repeated at intervals of seven days until a total of from 2.4 to 3.0 Gm. has been given, (b) Aqueous Isotonic Solution. — 50 mg. by intramuscular injection, preferably into the gluteal muscles, at intervals of 2 to 3 days, until a total of 12 to 18 injections has been given. Manufactured by the Abbott Laboratories, North Chicago. No U. S. patent or trademark. Ampules Potassium Bismuth Tartrate (Aqueoiis)-D. R. L., 2 cc: Each ampule contains potassium bismuth tartrate-D. R. L., 0.05 Gm. (equivalent to 34 mg. elemental bismuth) in an aqueous solution con- taining cresol 0.2 per cent and sucrose 6 per cent. Ampules Potassium Bismuth Tartrate with Butyn-D. R. L., 0.1 Gm.: Each ampule contains potassium bismuth tartrate-D. R. L. 0.1 Gm. and butyn 0.4 per cent with metaphen 1 : 20,000 in an emulsion of olive and almond oils, 2 cc. Ampules Potassium Bismuth Tartrate with Butyn-D. R. L., 0.2 Gm. : Each ampule contains potassium bismuth tartrate-D. R. L. 0.2 Gm. and butyn, 0.4 per cent with metaphen 1 : 20,000 suspended in peanut oil, 2 cc. Potassium Bismuth Tartrate (Aqueous)-D. R. L., 2.5 per cent: Potassum bismuth tartrate-D. R. L. 2.5 per cent in an aqueous solution containing cresol 0.2 per cent, and sucrose 6 per cent. Potassium Bismuth Tartrate with Butyn-D. R. L., 10 per cent: Each cc. contains potassium bismuth tartrate-D. R. L., 0.1 Gm. (equivalent to 64 mg. elemental bismuth), butyn 0.4 per cent and metaphen 1:20,000 suspended in peanut oil, 2 cc. QUINIOBINE. — Quinine bismuth iodide rendered soluble in olive oil by means of lecithin. Each cubic centimeter con- tains 0.158 Gm. of quinine bismuth iodide, equivalent to 0.03 Gm. of bismuth (Bi), rendered soluble in olive oil, with 0.22 Gm. of lecithin and 0.385 Gm. of benzyl alcohol. Actions and Uses. — Quiniobine is proposed as a means of obtaining the systemic effects of bismuth in the treatment of syphilis. It is claimed that, since in quiniobine and quinine bismuth iodide is soluble, the injections are usually only slightly painful and the dosage is more accurate than with suspensions of quinine bismuth iodide. Dosage. — Single dose for adults : 1 to 2 cc. twice a week ; the average course is from twelve to fourteen injections. Manufactured by Chemisch-Pharmazeutische A. G., Bad Homburg, Frankfurt-a-M. Germany. U. S. patent 7,777,173 (Sept 30, 1930; expires 1947). U. S. trademark 254,643. BISMUTH COMPOUNDS 139 Quiniobine Ampules, 2 cc: An oily solution, each 2 cc. of which con- tains quinine bismuth iodide 0.316 Gm., equivalent to 0.06 Gm, of bismuth (Bi) rendered soluble in olive oil, with 0.44 Gm. of lecithin and 0.77 Gm. of benzyl alcohol. Transfer exactly 2 cc. of quiniobine to a Kjeldahl flask, add 15 cc. of sulfuric acid, heat, add nitric acid a few drops at a time until the solution becomes almost clear. From time to time during the addition of the nitric acid, heat until brown fumes are not evolved. When the solution is clear, cool, add 10 cc. of water and heat until brown fumes are not evolved; cool, add 200 cc. of water, transfer to an Erlenmeyer flask, warm, add hydrogen sulfide until the bismuth is completely precipitated (if the bismuth does not come down readily, add ammonia water until it does), filter in a weighed Gooch crucible, wash with water, alcohol, chloroform and ether in this order, dry at 100 C., cool in a desiccator over sulfuric acid, weigh: the bismuth sulfide is equivalent to not less than 0.0585 Gm. nor more than 0.0615 Gm. of bismuth. The quinine bismuth iodide in quiniobine conforms to the N. N. R. standards for that substance. THIO-BISMOL.— Sodium bismuth thioglycollate.— A salt formed by the interaction of sodium thioglycollate and bismuth hydroxide. The product has the general formula Bi(SCH2C02Na)3, though it may differ slightly in composition from this formula. It contains approximately 38 per cent of bismuth. Actions and Uses. — Thio-bismol is proposed as a means of obtaining the systemic effects of bismuth in the treatment of syphilis (see preceding general article, Bismuth Compounds) ; it is a water-soluble compound, readily absorbable, and produces relatively little local injury. Dosage. — For the average adult, 0.2 Gm. (3 grains) admin- istered intramuscularly three times a week for a series of from twelve to fifteen doses. Manufactured by Parke, Davis & Company, Detroit. U. S. patent applied for. U. S. trademark 220,808. Ampoules Thio-Bismol 0.2 Gm.: Each ampule contains 0.2 Gm. (3 grains) of thio-bismol, to be dissolved in 1 cc. of sterile distilled water before administration. Ampoules Thio-Bismol, 2 Gm. Each ampule, representing ten doses, contains 2 Gm. (30 grains) of thio-bismol, to be dissolved in 20 cc. of sterile distilled water before administration. Thio-bismol occurs as a canary yellow hygroscopic noncrystallitie but granular substance possessing a garlic-like odor. It is freely soluble in water but the solutions are not stable. Add 1 drop of diluted hydrochloric acid to 1 cc. of a 2 per cent solution of thio-bismol solution: a heavy yellow precipitate separates that dissolves on the addition of another drop of acid. Add several drops of acetic acid to 1 cc. of a 2 per cent solution of thio-bismol: no precipitate forms. Add 3 drops of ammonia water to 1 cc. of a 2 per cent solution: a slight change of color and a slight precipitate occurs within one-half hour. Add 1 drop of sodium hydroxide solution to 1 cc. of a 2 per cent solution of thio-bismol: a precipitate forms, insoluble in excess of reagent. Add several drops of copper sulfate solution to 1_ cc. of a 2 per cent solution of thio-bismol: a precipitate forms that gives the suspension a murky greenish brown appearance. The pre- cipitate dissolves in sodium hydroxide solution, leaving a yellow solution (distinction from sodium or potassium bismuth tartrates) . Gently ignite an intimate mixture containing about 0.2 Gm. each of thio-bismol and sodium carbonate, cool, add 3 cc. of water, add sufficient diluted hydrochloric acid to make the solution acid and boil: lead acetate paper held in the mouth of the test tube blackens. 140 NEW AND NONOFFICIAL REMEDIES Extract 0.2 Gm. of thio-bismol with 10 cc. of chloroform or ether: no residue remains after the evaporation of the solvent (free thioglycol- lic acid). To 1 cc. of a 2 per cent solution of thio-bismol add sufficient diluted hj'drochloric acid to just dissolve the precipitate first formed, and add several drops of barium chloride solution: a precipitate does not appear. Heat an accurately weighed sample of thio-bismol weighing about 1 Gm. in a 100 C. oven for one hour, cool in a desiccator, and weigh: the sample does not lose more than 5 per cent in weight. Transfer an accurately weighed sample of thio-bismol weighing about 0.4 Gm. to an Erlenmeyer flask, dissolve in 100 cc. of water, add enough diluted hydrochloric acid to just dissolve the precipitate first formed, saturate with hydrogen sulfide until the bismuth is completely precipitated as bismuth sulfide, collect the precipitate in a prepared gooch crucible, wash with water, alcohol, ether, chloroform and ether in the order named, dry at 100 C., cool in a desiccator and weigh: the bismuth calculated from the bismuth sulfide is equivalent to not less than Z7 per cent nor more than 39.5 per cent in the original calculated to the dry substance. Evaporate the filtrate from the bismuth determination to a small bulk, transfer to a platinum dish, add sulfuric acid and evaporate to dryness; add a few drops of sulfuric acid, evaporate to dryness again, volatilize a small amount of ammonium carbonate from the dish, cool in a desiccator and weigh: the sodium calculated from the weight of sodium sulfate is not less than 12.23 per cent nor more than 13.04 per cent in the original substance calculated to the dry substance. QUININE BISMUTH IODIDE.— A substance of vari- able composition containing between 18 and 20.1 per cent of bismuth, between 48.7 and 53.5 per cent of iodine; and quinine. Actions and Uses. — Quinine bismuth iodide is proposed as a means of obtaining the systemic effect of bismuth in the treat- ment of syphilis (See preceding article, Bismuth Compounds). Quinine bismuth iodide is a red powder that clings to most surfaces even when it is dry. It is insoluble in water and most organic solvents. Treat about 0.5 Gm. of quinine bismuth iodide with 15 cc. of 20 per cent potassium hydroxide solution, warm, add 50 cc. of water, filter off the insoluble material, wash with water, dry at 100 C, extract with five 10 cc. portions of benzene, evaporate the benzene and dry the residue at 100 C.: the residue melts at 171 C. and gives the U.S. P. X tests for quinine. Ash the filter and undissolved precipitate in a quartz crucible: a yellow residue remains. Treat about 0.1 Gm. of quinine bismuth iodide with about 1 cc. of nitric acid: the material blackens. Add 10 cc. of water and boil: violet colored vapors are given off. Shake 0.030 Gm. of quinine bismuth iodide with 4 cc. of water, filter through a pledget of cotton, add 1 cc. of chloroform and 0.3 cc. each of diluted hydrochloric acid and ferric chloride solution, shake and allow to stand five minutes: the chloroform docs not acquire a purple tinge (iodides) . Shake 0.75 Gm. of quinine bismuth iodide with 4 cc. of potassium iodide solution, filter, add 1 cc. of chloroform to the filtrate, shake and allow to stand five minutes: the chloroform does not acquire a purple tingle (iodine). Transfer about 0.5 Gm. of quinine bismuth iodide, accurately weighed, to a wide mouth weighing bottle and dry in a vaccum over sulfuric acid to constant weight: it loses not more than 1 per cent in weight. Trans- fer about 0.5 Gm. of the original, accurately weighed, to a 600 cc. beaker, add nitric acid until the color changes to black, add 100 cc. of water and boil until clear and almost colorless, add an excfess of stronger ammonia water and 20 cc. of ammonium carbonate solution, allow to stand three hours, filter, wash the precipitate with water and ash, ignite in a weighed quartz crucible, add a few drops of nitric acid, evaporate and ignite to constant weight, cool in a desiccator and weigh: the BISMUTH COMPOUNDS 141 bismuth oxide weighed is equivalent to not less than 18 per cent nor more than 20.08 per cent of bismuth. Transfer about 0.12 Gm. of the original, accurately weighed, to a glass capsule, transfer this tube to a Carius tube containing 30 cc. of nitric acid and 0.2 Gm. of silver nitrate, seal and heat for seven hours at 210 C; cool, open the tube, transfer the contents to a large beaker and dilute to SOf) cc; allow to stand for four hours, filter through a Gooch crucible, wash with very dilute nitric acid (1 cc. diluted nitric acid in 50 cc. of water), dry at 100 C, cool in a desiccator and weigh: the silver iodide is equivalent to not less than 48.75 per cent nor more than 53.5 per cent iodine. SODIUM lODOBISMUTHITE. — Sodium bismuth iodide. — A compound formed by the interaction of bismuth chloride and sodium iodide in ethyl acetate solution, consisting essentially of hydratcd sodium iodobismuthite (sodium bismuth iodide) NasBiLs" with inorganic salts. It contains approximately 21 per cent bismuth (Bi), 62 per cent iodide (I") and 11 per cent water of hydration. Actions and Uses. — It is claimed for sodium iodobismuthite that it has the quality of appearing • in the spinal fluid and of penetrating the brain tissue. This claim and therapeutic indica- tions based upon it require further confirmation. Dosage. — See lodobismitol with Saligenin. Sodium iodobismuthite occurs as a red crystalline compound, odorless, or having only a faint acetic or ethyl acetate odor, permanent in dry air and possessing an astringent taste. It yields a clear solution with one part water; on moderate dilution of the solution, sodium iodobis- muthite hydrolyzes to form a black precipitate of bismuth iodide in a finely divided state, while on further addition of water the black pre- cipitate changes to red bismuth oxyiodide. Hydrolysis may be retarded by the addition of acids or alkali iodides. The aqueous solution is neutral or faintly acid to litmus. Sodium iodobismuthite dissolves readily and without decomposition in ethylene-glycol, propylene glycol, glycerin, anhydrous alcohol and ethyl acetate; it is insoluble in absolute ether, chloroform, carbon disulfide, petroleum ether, fixed oils and liquid petrolatum. On heating the product in an oven at 80 to 110 C, it loses water of hydration, with slight decomposition, leaving a maroon colored residue that becomes brown or black on aging, and that changes to red on exposure to moisture. Add 3 cc. of hydrochloric acid and 25 cc. of water to about 0.5 Gm. of sodium iodobismuthite, add an excess of stronger ammonia water, filter and wash the filter with water. Ignite the filter in a quartz crucible; the residue is yellow. A few drops of the filtrate imparts an intense yellow color to a nonluminous flame. Add 3 cc. of ferric chloride solution to a 10 cc. portion of the filtrate acidified with hydro- chloric acid, shake with 3 cc. of chloroform; a violet coloration is imparted to the chloroform. Add 5 cc. of chloroform to about 0.2 Gm. of sodium iodobismuthite and shake the mixture; the chloroform remains clear and colorless (free iodine and distinctimi from quinine bismutJi iodide). Percolate 0.1 Gm. of sodium iodobismuthite with 10 cc. of absolute ether; no residue remains after the evaporation of the solvent. Add 2 cc. of nitric acid to 1.5 Gm. of sodium iodobismuthite in a quartz dish, evaporate on a steam bath and ignite at red heat; dissolve in 5 cc. of hydrochloric acid; the solution meets the requiremetns of the Bettendorff test, U. S. P. X (arsenic). Add just suflRcient nitric acid to blacken 3 Gm. of sodium iodobismuthite contained in a 150 cc. beaker, add 100 cc. of water and boil; filter and evaporate the filtrate to 30 cc, filter again and divide the latter filtrate into portions of 5 cc. each. Mix one portion with an equal volume of dilute sulfuric acid: the liquid does not become cloudy (lead) ; precipitate another portion with a slight excess of ammonia water: the supernatant liquid does not exhibit a bluish tint (copper) : another portion is not immediately affected by barium nitrate solution (sulfate). To another portion, add 142 NEW AND NONOFFICIAL REMEDIES diluted hydrochloric acid; no precipitate is formed which is insoluble in a slight excess of hydrochloric acid, but soluble in ammonia water (silver) . Transfer about 0.4 Gm. of sodium iodobismuthite, accurately weighed, to a wide mouth weighing bottle and heat to constant weight in an oven at 110 C. ; the loss in weight is not less than 10.5 per cent nor more than 12.5 per cent. Transfer about 0.2 Gm. of sodium iodobismuthite, accurately weighed, to a beaker, dissolve in 3 cc. of hydrochloric acid and 125 cc. of water saturate the solution with hydrogen sulfide to precipitate completely the bismuth as bismuth sulfide, filter in a gooch crucible, wash with water, alcohol, chloroform and ether in this order, dry for one hour at 100 C., cool in a desiccator and weigh; repeat the washing with chloroform and ether and the drying at 100 C. until constant weight is attained; the bismuth sulfide weight is equivalent to not more than 21.8 per cent, nor less than 20.3 per cent bismuth. Transfer about 0.2 Gm. of sodium iodobismuthite, accurately weighed, to a 250 cc. beaker, add 10 cc. of a solution of acid silver nitrate (pre- pared by dissolving 1 Gm. of silver nitrate in 20 cc. of water and adding 5 cc. of nitric acid) and then 100 cc. of water, allow to stand two hours, filter, using a filter paper, wash well with water. Without allowing the precipitate to dry, puncture the filter and wash the pre- cipitate into a 250 cc. glass-stoppered Erlenmej-er flask, using 100 cc. of stronger ammonia water, agitate the solution, then allow the flask and contents to stand two hours, collect the precipiate on a prepared gooch crucible and wash it with diluted ammonia water, then with water; dry to constant weight at 100 C. The weight of silver iodide is equivalent to not less than 60 per cent nor more than 63 per cent iodide. Add 10 cc. of potassium iodide solution to the filtrate and heat on the steam bath until most of the ammonia has been removed, filter the solution and collect the precipitate on a prepared gooch crucible, wash with water, dry to constant weight at 100 C.; the weight of silver iodide is equivalent to not more than 0.7 per cent chloride. lODOBISMITOL WITH SALIGENIN.— A solution of sodium iodobismuthite (sodium bismuth iodide) and sodium iodide in propylene glycol (racemic 1,2 propylene glycol) con- taining saligenin and a small amount of acetic acid. Actions and Uses. — lodobismitol with saligenin seems to be well absorbed and to be excreted fairly rapidly. In laboratory animals the bismuth enters the brain in from 90 to 100 per cent of the cases. The claim is made for it that it will penetrate the brain in significant quantity in a great majority of persons treated. This claim, however, and therapeutic indications based on it require further confirmation. Z)oja(7r.— Intramuscular injections of 2 cc. repeated every three days. Two full days should elapse between injections. From 14 to 16 injections comprise a course of treatment. A rest period of from two to four weeks should elapse between courses. At each injection the patient would thus receive from 0.024 to 0.0276 Gm. of metallic bismuth (from 0.1154 to 0.1328 Gm. sodium bismuth iodide, and from 0.218 to 0.258 Gm. sodium iodide). Manufactured by E. R. Squibb & Sons, New York, by license of Stanford University. U. S. patent 1,890,508 (Dec. 13, 1932; expires 1949) and 1,927,210 (Sept. 19, 1933; expires 1950). U. S. trademark. Ampules lodobismitol with Saligenin 2 cc: Each 2 cc. contain from 0.1154 to 0.1328 Gm. of sodium iodobismuthite (equivalent to 0.024 to 0.0276 Gm. of bismuth) and from 0.218 to 0.258 Gm. of sodium iodide, dissolved in propylene glycol containing 4 per cent saligenin and 0.1 per BISMUTH COMPOUNDS 143 cent acetic acid. The total iodide per 2 cc. is equivalent to from 0.252 to 0.296 Gra. of sodium iodide. The specific gravity of iodobismitol with saligenin at 25 C. ranges from 1.167 to 1.175. The pn of iodobismitol with saligenin taken with a quinhydrone electrode ranges from 4.5 to 5.0. The refractive index at 25 C. ranges from 1.4609 to 1.4611. Transfer about 3 cc. of iodobismitol with saligenin, accurately weighed, to an Erlenmeyer flask, add 3 cc. of hydrochloric acid and 125 cc. of water; determine the bismuth according to the method out- lined under sodium iodobisniuthite: each cubic centimeter contains the equivalent of not less than 0.012 nor more than 0.0138 Gm. of bismuth. Add 10 cc. of a nitric acid-silver nitrate solution (prepared by dissolv- ing 1 Gm. of silver nitrate in 20 cc. of water and adding 5 cc. of nitric acid) to about 3 cc. of iodobismitol with saligenin, accurately weighed, and then add 100 cc. of water, allow to stand two hours, filter into a prepared Gooch crucible, and wash with very dilute nitric acid (5 cc. of diluted nitric acid to make 100 cc), dry to constant weight at 100 C. : weight of silver iodide is equivalent to not less than 0.135 nor more than 0.145 Gm. of iodide per cubic centimeter. The sodium iodobismuthite in iodobismitol with saligenin conforms to the New and Nonofficial Remedies standards for this substance. The propylene glycol used in the preparation of iodobismitol with saligenin complies with the following tests and standards: Propylene glycol, racemic 1,2 propylene glycol, CH2OH CHOH CH3, occurs as a viscous, colorless, almost odorless liquid, completely miscible with water, alcohol, chloroform and ether. The specific gravity at 25 C. ranges between 1.035 and 1.037. The refractive index at 25 C. ranges between 1.4312 and 1.4317. Transfer 25 cc. of propylene glycol to a distilling flask; determine the distillation range according to Method I of U. S. Pharmacopeia X: ninety-five per cent distils over at from 184 to 189 C. (corrected) at 760 mm. The refractive index of the distillate is the same as that of the material before distillation. Agitate 5 cc. of propylene glycol with 15 cc. of distilled water; insert a piece of red and a piece of blue litmus paper; the solution must be neutral to the litmus papers. Add 1 cc. of silver nitrate solution and 1 cc. of nitric acid to 5 cc. of propylene glycol diluted with 15 cc. of water: not more than a slight opalescence appears within fifteen minutes (chloride). Add 1 cc. of barium chloride and 1 cc. of diluted hydrochloric acid to 5 cc. of propylene glycol diluted with 15 cc. of water; no precipitate forms in fifteen minutes (sulfate). Bubble hydrogen sulfide through 5 cc. of propylene glycol diluted with 15 cc. of water: there is no opalescence and no change of color. Incinerate about 2 Gm. of propylene glycol, accurately weighed, in a platinum dish: the residue is not more than 0.05 per cent. The saligenin used in the preparation of iodobismitol with saligenin complies with the following tests and standards: Saligenin, ortho-hydroxy benzyl alcohol, salicyl alcohol, occurs a.s white monoclinic plates. It is soluble in water, chloroform, and the fixed and volatile oils; freely soluble in alcohol and ether. The aqueous solution is neutral to litmus paper. It melts between 85 and 86 C. Add 3 cc. of aniline to 1 Gm. of saligenin and heat just below the boiling point for 6 minutes. Add 15 cc. of alcohol and heat to boiling; add warm water (80 C.), a few cc. at a time, but stop short of the point where the precipitate formed fails to dissolve at this temperature, allow to cool, filter and dry the crystals: the melting point falls between 106 and 108.5 C. (ortho-hydroxy benzyl aniline). Saligenin is not precipitated by the usual alkaloidal reagents. Add a few drops of ferric chloride solution to about 0.1 Gm. of saligenin: the solution becomes bluish violet. Add a few drops of sulfuric acid to about 0.01 Gm. of saligenin: the particles instantly become cherry red, while the acid is but slightly colored (distinction from other local anesthetics). Add 100 cc. of cold water to 0.3 Gm. of saligenin in a beaker: the substance is completely soluble and the solution is colorless (substances insoluble in cold water). Add 1 cc. of sodium hydroxide solution to 144 NEW AND NONOFFICIAL REMEDIES 5 cc. of a saturated solution of saligenin. The yellow color produced is not darker than that of a solution made by diluting 0.3 cc. of U. S. P. XI ferric chloride colorimetric solution to 5 cc. with distilled water, when compared immediately in a container of the same dimensions (limit of salicyl aldehyde). Add 1 cc. of silver nitrate solution and 1 cc. of diluted nitric acid to 5 cc. of a saturated solution of saligenin: not more than a slight opalescence appears (limit of chloride). Add. 1 cc. of barium chloride solution and 1 cc. of diluted hydrochloric acid to 5 cc. of a saturated solution of saligenin : no precipitate appears (absence of sulfate). Dissolve about 0.40 Gm. of saligenin (weighed to the second decimal place) in 100 cc. of water; add phenolphthalein and titrate with hundredth normal sodium hydroxide solution: not more than 9 cc. is required (limit of acids). Transfer about 1 Gm. of saligenin, accurately weighed, to a wide mouthed weighing bottle, dry over phosphorus pentoxide for twenty- four hours: the loss in weight is not more than 0.1 per cent. Incin- erate about 1 Gm. of saligenin. accurately weighed: the ash is not more than 0.05 per cent. SODIUM POTASSIUM BISMUTHYL TARTRATE. — A basic water soluble sodium potassium bismutb tartrate con- taining from 40.75 to 41.25 per cent of bismuth. Actions and Uses. — Sodium potassium bismuthyl tartrate is proposed as a means of obtaining the systemic effects of bismuth in the treatment of syphilis (See preceding article, Bismuth Compounds). Sodium potassium bismuthyl tartrate is a white, heavy powder, solu- ble in water and insoluble in organic solvents. During the ignition of about 0.1 Gm. of sodium potassium bismuthyl tartrate in a quartz crucible, a small globule of metallic bismuth forms that oxidizes on extended heating. The residue is yellow and alkaline to litmus, and effervesces with acids. Transfer 0.1 Gm. of sodium potassium bismuthyl tartate to a test tube, add 5 cc. of water and sufficient diluted hydrochloric acid to dissolve the precipitate first formed and add 0.5 cc. of barium chloride solution: no cloudiness appears within 2 minutes. Transfer 0.1 Gm. of sodium potassium bismuthyl tartrate to a test tube, add 5 cc. of water and sufficient diluted nitric acid to dissolve the precipitate first formed and add 0.5 cc. of silver nitrate solution: no precipitate appears. A sample of s9dium potassium bismuthyl tartrate loses not more than 0.3 per cent of its weight when dried in a vacuum over sulfuric acid. Transfer about 0.5 Gm. of sodium potassium bismuthyl tartrate, accurately weighed, to an Erlenmeyer flask, add 100 cc. of water, add diluted hydrochloric acid a drop at a time until the precipitate that forrns redissolves, saturate with hydrogen sulfide, filter, wash suc- cessively with water, alcohol, chloroform and ether, dry at 100 C., cool in a desiccator and weigh: the bismuth sulfide weighed is equivalent to not less than 40.75 per cent nor more than 41.25 per cent of bismuth. TARTRO-QUINIOBINE.— A suspension of quinine bis- muth iodide and sodium potassium bismuthyl tartrate in olive oil. each cubic centimeter containing quinine bismuth iodide, 0.072 Gm., sodium potassium bismuthyl tartrate, 0.032 Gm., and camphor, 0.003 Gm. Actions and Uses. — Tartro-quiniobine is proposed as a means of obtaining the systemic effects of bismuth in the treatment of sj'^philis (See preceding article, Bismuth Compounds) ; it is designed to secure both early action, through the presence of BROMINE DERIVATIVES 145 the water-soluhlc sodium potassium bismuthyl tartrate, and pro- longed action through the insoluble quinine bismuth iodide com- ponent of the mixture. Dosage. — From 1 to 2 cc, administered intramuscularly twice a week. These should be separate doses from ampules, as bulk dosage has been found to be inexact. Manufactured by Chemisch-Pharniazeutische A. G., Bad Homburg, Frankfurt a. M., Germany. No U. S. patent. U. S. trademark 364,048. Tartro-Qxciniobinc Ampules. 2 cc. Transfer 2 cc. of the tartro-quiniobine. well mixed to a weighed Gooch crucible and percolate with petroleum benzine until all of the soluble part is extracted, dry in an oven at 50 C., cool in a desiccator over sulfuric acid and weigh: the residue weighs not more than 0.215 Gm., nor less than 0.20 Gm. Place the crucible containing the residue just weighed in an 800 cc. beaker and add 5 cc. of nitric acid to the crucible; when the acid has percolated through, tip the crucible over, add 100 cc. of water, stir until the asbestos is washed out of the crucible, boil until the solution is nearly colorless, remove the crucible by means of a glass rod, wash the crucible adding the washings to the solution, filter the asbestos using a large filter paper, wash with very dilute nitric acid (20 cc. diluted nitric acid diluted to 100 cc.) until the bismuth is all in the solution, add an excess of stronger ammonia water and 20 cc. of ammonium carbonate solution, heat to boiling and allow to stand three hours, filter through ashless paper, ignite in a quartz crucible, cool, add a few drops of nitric acid, evaporate and then ignite, cool in a desiccator over sulfuric acid and weigh: the residue when calculated to bismuth is not more than 0.0550 Gm., nor less than 0.0523 Gm. The quinine bismuth iodide and the sodium potassium bismuthyl tartrate in tartro-quiniobine conform to the N. N. R. standards for these substances. BROMINE DERIVATIVES Synthetic compounds containing bromine have been produced with the purpose of securing the sedative action of bromide ion without the objectionable effects of the alkali bromides. These compounds split off bromine ions in the system, the decomposi- tion being due to the oxidation of the organic substance with which it is combined ; but bromine which is too firmly bound may fail to exert its typical effects. As the usual indications for bromide action in the organism require a prompt and power- ful action on the cells to produce sleep, to abolish reflexes or to arrest an epileptic paroxysm, the synthetic compounds are likely to fail as substitutes for the alkali bromides because their bromide ion is liberated too slowly. The introduction of bromine into compounds already possessing hypnotic or sedative powers may result in increasing the efficiency of these compounds. BROMETONE. — Tribromtertiarvbutylalcohol. — Acetone- bromoform. — CBrs.CCOH) (CH3).CH.,— l,l,l-tribrom-2-methyl- propan-2-ol produced by the reaction of acetone on bromoform. Actions and Uses. — Brometone is claimed to have a sedative action similar to that of the bromides without the disadvantage of producing bromism. In doses of 0.3 Gm. (5 grains), four or five times a day, in adults, it is claimed that brometone causes 146 NEW AND NONOFFICIAL REMEDIES no unpleasant results, produces no disturbance of the digestive organs, and has no appreciable effect on the secretions. Its action is prompt and its effect is manifest for several hours. In doses exceeding 1.6 Gm. (25 grains), daily, it may produce dizziness, vertigo, anorexia and mental hebetude, all of which symptoms disappear on discontinuance of its use. Therapeu- tically, this drug has been said to be useful in mild conditions of excitation and insomnia, in so-called narcotic abstinence, in hysteria, and in nervous affections generally. It relieves some forms of cough and it is said to produce amelioration in some cases of epilepsy. It has been used to relieve dizziness due to labyrinthine disturbances. Dosage. — The dose is 0.3 Gm. (5 grains), dry or in capsules, to be repeated two or three times during twenty-four hours. Manufactured by Parke, Davis & Company, Detroit. U. S. trademark. Brometone Capsules, 5 grains. Brometone occurs in fine white, prismatic crystals which possess a camphoraceous odor and taste. It is slightly soluble in water; soluble in alcohol, ether, benzin and most organic solvents. It melts at about 176 C. and volatilizes on exposure to air. BROMURAL.— (CH3.CH(CH3)CHBr.CO)HN.CO.NH2.— 2-monobromisovalerylurea, obtained by the interaction of urea with bromisovaleryl bromide. Actions and Uses. — Bromural is a nerve sedative which pro- duces sleep in mild cases of insomnia without markedly affect- ing the circulation or respiration. All action by bromural is said to cease after from three to five hours. In many cases, however, the sleep caused by the preparation continues beyond the limits of its action. It is claimed to be useful as a nerve sedative and for the purpose of inducing sleep in functional nervous disease. Bromural is not effective in cases of insom- nia associated with pain, cough, angina pectoris or delirum. Dosage. — As a nerve sedative, 0.3 Gm. (5 grains), three times daily; as a hypnotic at bedtime, 0.6 Gm. (10 grains), which dose may be repeated if advisable during the night, after the action of the first dose has ceased. Manufactured by E. Bilhuber, Inc., Jersey City, N. J., by license of the Chemical Foundation, Inc. (Bilhuber-Knoll Corporation, Jersey City, N. J., distributor). U. S. patent 914,518 (March 9, 1909; expired). U. S. trademark 61,165. Bromural Tablets, 5 grains (0.3 Gm.). Bromural forms small, white, almost tasteless needles which are easily soluble in hot ^Y^ter, ether, alcohol and alkalis, but less readily in cold water. It sublimes on heating and melts at from 147 to 149 C. Bromural can be precipitated from a 10 per cent sodium hydroxide solution with acids. The presence of bromine may be demonstrated by fusion with sodium carbonate and potassium nitrate and testing for a bromide with silver nitrate solution. On heating the alcoholic solution of bromural with sodium ethylate for several hours on the water bath, sodium bromide will precipitate. If this is filtered off and the filtrate evaporated, a crystalline mass remains which can be recrystallized from water. This is dimethylacrylic acid, melting at 280 C. If 1 Gm. of bromural is boiled for about one minute with BROMINE DERIVATIVES 147 10 per cent solution of sodium hydroxide, ammonia obtained from the urea will be given off. If the hot liquid is then cooled, acidified with nitric acid and extracted with ether, and the ether evaporated, an oil fluid 1-brom-isovaleric acid, which has the specific odor of valeric acid, will remain. The biuret reaction cannot be obtained. On melting bromural and adding concentrated sodium hydroxide solution and cop- per sulfate, no color reaction will take place. CARBROMAL. — Bromdiethylacetylurea. — For standards see the U. S. Pharmacopeia under Carbromalum. Actions and Uses. — Carbromal is said to be an efficient and prompt sedative, reducing excitement and promoting sleep in conditions in which a powerful hypnotic is not required. In therapeutic doses it is said not to exert any unfavorable influence on the respiration or heart action. The sleep produced is said to be restful, dreamless and exceptionally free from unpleasant by-effects and sequelae. Carbromal is stated to be useful as a sedative and mild hyp- notic in neurasthenia, hysteria, cardiac neuroses with tachy- cardia, chorea, mental disorders with moderate excitement, insomnia due to various internal diseases, etc. Dosage. — As a sedative from 0.3 to 0.6 Gm. (5 to 10 grains), given in cold water, repeated three or four times daily if necessary; as a hypnotic from 0.6 to 1.3 Gm. (10 to 20 grains), followed by a drink of hot, sweetened water or weak tea. Adalin. — A brand of carbromal-U. S. P. Manufactured by Winthrop Chemical Company, Inc., New York. U. S. patent 983,425 (Feb. 7, 1911; expired). U. S. trademark 81,136. Adalin Tablets, 5 grains (0.3 Gm.). SABROMIN. — Calbroben. — Calcium Dibrombehenate Ca(C2iH4iBr2.COO)2. Sabromin contains not less than 28.5 per cent of bromine. Actions and Uses. — Sabromin is converted in the stomach into dibrombehenic acid, and this is absorbed from the intes- tinal tract. The absorption and elimination are slower than that of the inorganic bromides ; hence, sabromin is not adapted to conditions in which a rapid saturation of the system with bromine is required. It is indicated in conditions in which the bromides cannot be administered for continued periods with- out gastric disturbance or in which brominism is caused readily. It is claimed that sabromin is of value in conditions in which a mild sedative action is desired, particularly in con- ditions requiring prolonged administration, and that because of absence of taste, it is of value in pediatric practice. Dosage. — For adults, from 0.3 to 1.2 Gm. (5 to 20 grains). When administered in the form of tablets, these should be masticated before swallowing. Manufactured by Winthrop Chemical Company, Inc., New York. U. S. patent 848,230 (March 26, 1907; expired). U. S. trademark 74.091. 148 NEW AND NONOFFICIAL REMEDIES Sabromin Tablets, 8 Grains. Sabromin is a yellowish-white powder; odorless and tasteless. It is insoluble in water and alcohol, but soluble in ether, chloroform, acetone, benzene, petroleum benzin and carbon tetrachloride. Shake about 0.5 Gm. of sabromin with 10 cc. of boiling water and filter. The filtrate is neutral to litmus paper and gives not more than a slight opalescence with silver nitrate solution (soluble bromides), and no precipitate with barium chloride solution (sulfates). Heat about 0.2 Gm. of sabromin with 5 cc. of sodium hydroxide solution for one minute. Dilute the solution with 5 cc. of water, acidulate with acetic acid, filter and divide the filtrate into two por- tions. To one portion add ammonium oxalate solution. A white pre- cipitate results (calcium); shake the second portion with 5 cc. of dilute hydrochloric acid; add 10 drops of chlorine water and 5 cc. of chloro- form and agitate the mixture: after separation, the chloroform shows a yellow coloration (bromine). Dry about 1 Gm. of sabromin, accurately weighed, to constant weight at 100 C. : the loss is not more than 2.5 per cent (limit of moisture). Dissolve 0.25 Gm. of sabromin in 5 cc. of chloroform and add 3 drops of absolute alcohol: not more than a slight opalescence is produced, and only a very slight precipitate occurs after standing for twenty-four hours. Boil about 2 Gm. of sabromin, accurately weighed, in a reflux apparatus with 100 cc. of 10 per cent alcoholic potassium hydroxide for six hours. Transfer the solution to a porcelain evaporating dish and evaporate the alcohol over a water bath. Dilute the residue with a little water, pour the solution into a 500 cc. flask, and add 40 cc. of 30 per cent nitric acid. Dilute to 500 cc. with water, shake well and filter. To 250 cc. of the filtrate add 20 cc. of nitric acid and 50 cc. of tenth-normal silver nitrate solution. Titrate the excess of silver salt with tenth-normal potassium sulfocyanate solution, using ferric ammo- nium sulfate as indicator: the tenth-normal silver nitrate consumed corresponds to not less than 28.5 per cent of bromine. Heat about 2 Gm. of dried sabromin, accurately weighed, until most of the carbon has been consumed; extract the residue with hot, diluted hydrochloric acid; filter; add a slight excess, each of ammonia water and ammonium oxalate solution; collect the preciiiitate, dry it and ignite it to calcium oxide in the usual way; the weight of calcium oxide corresponds to not less than 3.5 per cent of calcium. CALCIUM COMPOUNDS Calcium performs important function.s, especially in forming the structure of bone, in the regulation of nervous and muscular activity, and in the coagulation of the blood. In rickets, osteo- malacia and osteopsathyrosis there is defective deposition of calcium in the bones, but this is usually due to factors other than a deficient supply of calcium ; and these conditions are not benefited by the administration of calcium salts except in rare experimental conditions, when calcium has been almost totally lacking in the diet. When the calcium content of the blood is low, as in infantile and parathyroid tetany, the admin- istration of calcium salts results in a temporary increase in blood calcium and a cessation of the symptoms, but unless the cause of the condition is removed, the concentration sinks rapidly following discontinuance of calcium administration. Administration of the parathyroid hormone leads to an increase in blood calcium even though additional calcium is not supplied. The administration of calcium salts has been shown to lessen certain transudation phenomena. There is some clinical evi- CALCIUM COMPOUNDS 149 clence, not altogether conclusive, for the use of calcium salts for various types of urticaria and angio-neurotic edema. Intra- venous administration of suitable calcium compounds has been shown to be effective in lessening peristalsis and therefore is useful in certain types of intestinal and gallbladder pain (Aub and Bauer, /. A. M. A. 96:1216, and Am. J. Physiol. 97:1421, 1931). Calcium chloride has been shown to be useful in treat- ing edema in certain types of B right's disease and the ascites of cirrhosis of the liver. It is unreliable against ascites and other generalized edemas. It has been reported as being effective in preventing arsphenamine reactions and also in certain dermatoses, as dermatitis herpetiformis, lichen rubra and erythema pernio, but further observations are needed in these directions. A deficiency of calcium in the circulating fluids leads to increased excitability of the neuromuscular sys- tem, as is seen for example in tetany. The administration of calcium salts decreases the neuromuscular irritability in such cases. The intravenous infusion of soluble calcium salts causes a constriction of the blood vessels and a marked contraction of the pupils. Calcium is necessary for blood coagulation, but a large excess lengthens the coagulation time. The effect of calcium on blood coagulation has led to its injudicious use in hemorrhagic con- ditions, such as hemophilia, purpura and the intestinal hemor- rhage of typhoid fever. It is very improbable that it is effective in any of these conditions, as in all of them the blood contains an adequate amount of calcium. It has been claimed that the administration of calcium salts to jaundiced patients is effective in preventing postoperative hemorrhage. There is, however, very little evidence that this is the result of shortening of the coagulation time. It has been shown that the administration of calcium salts tends to diminish the toxicity of carbon tetra- chloride. When calcium chloride is administered, the basic portion of the molecule is, to a large extent, excreted by way of the bowel. The acid portion behaves in the same manner as hydrochloric acid from other sources, decreasing the alkali reserve of the body and increasing the acidity of the urine. Large doses of calcium chloride may produce acidosis. Calcium chloride is one of the substances which may be administered to render the urine acid. Intravenously, overdoses of calcium compounds may be fatal by paralyzing the heart and central nervous system. The average normal diet usually contains just about enough calcium for the needs of the body, but when unusual diets are taken there may be a calcium deficiency. This may be remedied by the administration of natural foods having a high calcium content, such as milk, green vegetables and Qgg yolk. The administration of special preparations of calcium salts is indi- cated only in special pathological conditions, especially tetany. The administration of calcium salts in the treatment of rickets or other diseases associated with deficient calcification is in itself inefficient, but may be used as an adjunct in the treatment 150 NEW AND NONOFFICIAL REMEDIES when vitamin D is also administered. On oral administration, calcium chloride is effective particularly in tetany owing to the acidosis (which is limited to the body fluids) resulting from its administration. The absorption of calcium chloride from the intestines probably plays no greater part than that which would result from the administration of any other calcium salt. The lactate and gluconate are, however, more pleasant to take than calcium chloride and are less irritating. Calcium chloride cannot be used for subcutaneous or intra- muscular injection as it is too irritating. It may, however, be used intravenously. For hypodermic or intramuscular use, the less irritant lactate or the non-irritant gluconate are employed. AFENIL. — Calcium chloride urea. — CaCl2.4(NH2)2CO.— Afenil is a molecular compound of calcium chloride and urea. Actions and Uses. — Afenil has the actions of calcium chloride. It is claimed that afenil solutions, when administered intravenously, are better tolerated and less irritating than solutions of calcium chloride. Dosage. — Afenil is marketed in ampules containing 10 cc. of a 10 per cent solution of afenil. Each injection consists of the entire contents of one ampule. Manufactured by Knoll and Co., Ludwigshafen a. R., Germany (the Bilhuber-Knoll Corporation, Jersey City, N. J., distributor). No U. S. patent. U. S. trademark 170,032. German patent 306,804. Ampules Afenil: Each ampule contains 10 cc. of a sterile 10 per cent solution of afenil (equivalent to 0.11 Gm. Ca.). Afenil occurs as colorless crystals; non-hygroscopic; very soluble in water. The calcium content of afenil is determined by precipitating with ammonium oxalate in the usual way and weighing as calcium oxide. The urea content of afenil is determined by an estimation of nitrogen by the Kjeldahl method. CALCIUM GLUCONATE.— "The normal calcium salt of gluconic acid. It yields not less than 12.4 per cent and not more than 12.8 per cent of CaO." U. S. P. For standards see the U. S. Pharmacopeia under Calcii Gluconas. Actions and Uses. — Calcium gluconate is used to obtain the therapeutic effects of calcium. It is more palatable than cal- cium chloride for oral administration, and for hypodermic or intramuscular use is nonirritant. Dosage. — Orally, for adults, 5 Gm. (75 grains) three times a day; for children, 2 Gm. (30 grains) three times a day. Intra- muscularly or intravenously, for adults, 1 Gm. administered every day, on alternate days or every third day ; for children, 0.2 to 0.5 Gm. administered every day, on alternate days or every third day. Ampule Compound Solution of Calcium Gluconate 10%, 10 cc.-U. S. S. P. Co. — A solution containing in each 10 cc. calcium gluconate, 1 Gm. 051/2 grains); dextrose anhydrous, 0.5 Gm. (714 grains); citric acid, 0.037 Gm. 0/2 grain), and lactic acid, 0.1 Gm. (1J4 grains). Prepared by the United States Standard Products Company, Wood- worth, Wis. U. S. patent applied for. CALCIUM COMPOUNDS 151 Calcium Gluconate-Pfizer. — A brand of calcium gluconate- U. S. P. Manufactured by Chas Pfizer & Co., Inc., Brooklyn, N. Y. No U. S. patent. U. S. trademark 142,090. Calcium Gluconate-Sandoz. — A brand of calcium gluco- nate-U. S. P. Manufactured by the Sandoz Chemical Works, Basle, Switzerland (Sandoz Chemical Works, Inc., New York, distributor). U. S. patent 1,648,368 (Nov. 8, 1927; expires 1944). Ampules Calcium Gluconate-Sandoz: Each ampule contains 10 cc. of a 10 per cent stabilized supersaturated solution of calcium gluconate- Sandoz. Calcium Gluconate-Merck. — A brand of calcium gluconatc- U. S. P. Manufactured by Merck & Co., Inc., Rahway, N. J. No U. S. patent or trademark. CALCIUM PEROXIDE.— See Peroxides, Metallic. TRIBASIC CALCIUM PHOSPHATE.— Calcii Phos- phas Tribasicus. — Tertiary Calcium Phosphate, Ca3(P04)2. Tribasic calcium phosphate contains approximately 85 per cent of Ca3(P04)2. Actions and Uses. — Tribasic calcium phosphate has been pro- posed for use as an antacid. It has the advantage over alkaline hydroxides such as magnesium hydroxide and alkali carbonates such as sodium bicarbonate, in that, being less soluble, it tends to neutralize the excess of acid in the stomach but produces less systemic alkalization. It has been claimed that tribasic calcium phosphate is somewhat constipating. It has been shown that some of the calcium is absorbed, hence this salt may be used to obtain the therapeutic effects of calcium. Dosage. — From 1 to 5 Gm, (15 to 75 grains). Ucoline Calcium Phosph0) ; at the same time CO water is given ofif yielding a product having the structural formula The product is closely related to phenolphthalein and its deriva- tives (which are described in the next section), differing chiefly in the presence of the oxygen molecule between the two ortho positions of the resorcinol nuclei. In common with the phthaleins, it forms salts with alkali whereby a rearrangement takes place and the quinoid group is formed. Fluorescein is easily bromin- ated, the tetrabrom compound being the beautiful dye eosin. Fluorescein has been combined with one molecule of mercury _( — HgOH), the sodium salt of the combination being flumerin; in mercurochrome soluble, two of the hydrogen atoms of flumerin have been replaced by two bromine atoms. Actions and Uses. — Fluorescein has been employed mainly as a diagnostic agent in ophthalmologic work. Flumerin and mer- curochrome soluble are bactericides ; flumerin has also been employed in the treatment of syphilis. FLUORESCEIN. — Fluoresceinum. — Resorcinolphtha- lein (a term not strictly correct but commonly used). — Dioxy- fluoran. — 0:(C6H30H)2:C.C6H4.COO. — The anhydride of fluoresceinic acid, O :(C6H30H)2:C(OH).C6H4(COOH). Actions mid Uses. — The soluble sodium salt of fluorescein (fluorescein 2 Gm., sodium bicarbonate 3 Gm., water to make 100 cc.) has been used for the diagnosis of corneal lesions and the detection of minute foreign bodies embedded in the cornea. While a weak solution of fluorescein will not stain the normal cornea, ulcers or parts deprived of epithelium will become green and remain so for a time ; foreign bodies will appear surrounded by a green ring; loss of substance in the conjunctiva is indicated by a yellow hue. Fluorescein also reveals defects or disease of the efidothelium of the cornea, producing a deep coloration of the diseased area. DYES 203 Fluorescein is prepared by the fusion of phthalic anhydride and resorcinol at from 195 to 200 C. till the mass becomes solid. This is extracted with water and the residue dissolved in potassium hydroxide solution, which is then filtered and the fluorescein pre- cipitated with acid. Fluorescein is an orange red powder, insoluble in water, ether, chloroform and benzol; soluble in hot glacial acetic acid and boiling alcohol. It dissolves in alkaline solution with formation of a salt. The alkaline solution by transmitted light is red; by reflected light it has a green fluorescence even in very dilute solution. When fluores- cein is boiled with chalk and water, the calcium salt of fluorescein is formed, which is recognized by its red brown color and green sheen. Fluorescein-Merck. — A brand of fluorescein-N. N. R. Merck & Co., Inc., Rahway, N. J., distributor. MERCUROCHROM E.— See Mercury and Mercury Compounds. The Phenolphthalein Dyes Phenolphthalein — long used by chemists as an indicator before its tlierapeutic properties were discovered — is a condensation product of phthalic anhydride and phenol. In neutral and acid mediums it exists in a form in which there is no quinoid group, ONa C O COONa Quinoid Group but the presence of alkali (/'h=8 to 10) causes the characteristic rearrangement with typical salt formation and the presence of a quinoid group whereby the beautiful red color is formed. This reaction is also characteristic of other members of the series. Phenolsulfonphthalein — which chemists also use as an indicator — contains an SO2 group in place of the CO group in the phthalic anhydride nucleus. In phenoltetrachlorphthalein, the four hydrogen atoms in the benzene ring belonging to the phthalic acid nucleus have been replaced by chlorine; in tetra- bromophenolphthalein, the four bromine atoms are in the phenol groups, two in each, which, it will be noted, is a different substitution than in the case of phenoltetrachlorphthalein. Actions and Uses. — All of the compounds of the phenol- phthalein type are used in medicine as diagnostic agents except phenolphthalein itself. Also phenolphthalein is used not because of its property of color formation, but because of its action on the intestine. Phenolsulfonphthalein and phenoltetrachlor- phthalein are used because they pass unchanged through the body and at the same time have the property of intense color 204 NEW AND NONOFFICIAL REMEDIES formation when the excretions are collected and alkalinized. Bromsulphalein is used in a somewhat analogous way, but instead of determining the amount in the excretion of the bile, the amount (not excreted) in the blood gives an index of liver function. Tetrabromophenolphthalein and tetraiodophenolphtha- lein — which are employed in the form of the sodium salts — are not used because they are dyes per se, but rather as carriers of bromine or iodine; they appear in the gallbladder in sufficient concentration to permit the heavy halogen molecules to cast a shadow to the roentgen rays. BROMSULPHALEIN-H. W. & D.— Disodium phenoltet- rabromphthaleinsulfonate. — O.CO.QBr4.C[C6H3(OH)S03Na]2 The disodium salt formed by the interaction of tetrabromo- phthalic acid (or anhydride) and phenol with subsequent sul- fonation. It contains from 2)7 to 38 per cent of bromine. Actions mid Uses. — Bromsulphalein-H. W. & D., after intra- venous injection into normal rabbits, is excreted in the bile to the extent of about 85 per cent in one hour. Normally it is rapidly removed from the blood stream, but when the liver is extirpated it is retained in the blood stream almost completely. In normal animals the drug appears in the urine in traces only or not at all. Experiments on man have been in accord with animal experiments. Bromsulphalein-H. W. & D. is used as a test of liver func- tion; the amount remaining in the blood stream after intra- venous injection, as determined colorimetrically, is considered a measure of hepatic dysfunction. Dosage. — 0.002 Gm, per kilogram of body weight is injected intravenously in 5 per cent aqueous solution without dilution. To carry out the test, the solution of salt may be injected into an arm vein; thirty minutes after the injection, a specimen of blood (from 4 to 5 cc.) is drawn, preferably from the opposite arm, by allowing the blood to run from the needle directly into a dry test tube ; after the blood has coagulated it is centrifugal- ized and the serum is pipetted into two small test tubes ; to one of these is added one or two drops of a 10 per cent solution of sodium hydroxide, and to the other tube, a drop of hydrochloric acid; the amount of dye present is determined by comparison with a series of standards. Manufactured by Hynson, Westcott & Dunning, Baltimore. U. S. patent and trademark applied for. Solution Bromsulphalein-H. IV. & D.: Ampules containing 3 cc. of a sterile 5 per cent solution of bromsulfalein-H. W. & D. Bromsulphalein-H. W. & D. is a white, crystalline powder, soluble in water, insoluble in alcohol or acetone. The aqueous solution is almost colorless. To a few cubic centimeters of a 1 per cent solution of bromsulpha- lein-H. W. & D., add a drop of hydrochloric acid: no precipitate is formed. To 3 cc. of a 1 per cent solution of bromsulphalein-H. W. & D., add a drop of sodium hydroxide solution; an intense bluish- purple color results. To 2 cc. of a 1 per cent aqueous solution of the DYES 205 salt, add a drop of hydrochloric acid, heat to boiling and add an equal volume of boiling 1 per cent barium chloride solution: the liquid remains clear white hot (absence of sulfate); on cooling, crystals of a difficultly soluble barium salt form which under the microscope appear as groups of platelets (distinction from barium sulfate). To a 1 per cent solution of the salt, add an equal volume of 5 per cent calcium chloride solution: no precipitate forms, even after the addition of an equal volume of alcohol. Acidify a 1 per cent solution of the salt with nitric acid silver nitrate solution: not more than a slight opal- escence is produced (limit of ionic halogen). To each of a series of phosphate buffer mixtures from pH 6.8 to pB. 8.8 of 5 cc. each, add a drop of 5 per cent solution of bromsulphalein-H. W. & D.: there is no color at 6.8; a faint perceptible purple at 7.0; the color increases in intensity up to 8.4. Determine the bromine content of bromsulphalein-H. W. & D. by the lime or the sodium hydroxide combustion method: the bromine content is from 37 to 38 per cent. PHENOLSULFONPHTHALEIN.— Phenol Red. For standards see the U. S. Pharmacopeia under Phenol- sulfonphthaleinum. Actions and Uses. — Solutions of phenolsulfonphthalein in- jected into the tissues are readily absorbed, and are excreted mainly in the urine. A very small amount is excreted by the feces. Phenolsulfonphthalein is used for determining the functional activity of the kidney. When injected intramuscularly or intra- venously, it begins to be excreted in normal cases in from five to ten minutes. In case of a deficient functional activity, the first appearance of its secretion is delayed. In normal cases, after intramuscular injections, almost the total amount is excreted within two hours (from 60 to 80 per cent). Failure to excrete nearly the full amount within two hours indicates a deficient functional activity, and the degree of this functional deficiency may be estimated by the proportionate amount excreted within two hours. The average normal eliminations after intravenous administration are from 35 to 45 per cent in fifteen minutes, from 50 to 65 per cent in thirty minutes, and from 65 to 80 per cent in the first hour. Dosage. — One cc. of a sterile solution, containing 0.006 Gm. of phenolsulfonphthalein as the monosodium salt, is injected into the lumbar muscles. Great care must be taken that all of the solution is injected. From twenty minutes to half an hour before administering the test, the patient is given from 200 to 400 cc. of water in order to insure free urinary secretion; otherwise delayed time of appearance may be due to lack of secretion. Under aseptic precautions a catheter is introduced and the bladder is completely emptied, or the patient is allowed to empty it voluntarily. The time is noted, and 1 cc. of a carefully pre- pared solution of the phenolsulfonphthalein containing 6 mg. to the cubic centimeter is accurately administered intramuscu- larly or intravenously by means of an accurately graduated syringe. 206 NEW AND NONOFFICIAL REMEDIES The urine is allowed to drain into a test tube in which has been placed a drop of 25 per cent sodium hydroxide solution, and the time of the appearance of the first faint pinkish tinge is noted. In patients having no urinary obstruction, the catheter is withdrawn at the time of the appearance of the drug in the urine. If injection is made intramuscularly, the patient is instructed to void into a receptacle at the end of one hour and ten minutes, and into a second receptacle at the end of the second hour. If injection is made intravenously , the patient is instructed to void into a receptacle at the end of fifteen or thirty minutes or one hour. When the passing of the catheter is disagreeable and no urinary retention is present, its use can be dispensed with and the time of appearance of the drug can be disregarded. The urine collected is made alkaline with a 25 per cent solu- tion of sodium hydroxide and then diluted to 1 liter. The solution is thoroughly mixed and a small filtered portion taken, to compare with the standard which is used for all of these esti- mations. Comparison is made in a colorimeter, a special form of which has been devised for this purpose. Phenolsulfonphthalein-H. W. & D. — A brand of phenol- sulfonphthalein-U. S. P. Prepared by Hynson, Westcott & Dunning, Baltimore. Phenolsulfonphthalein Ampnies-H. W. & D.: One cc. of solution contains 6 mg. of phenolsulphonphthalein, in the form of the monosodium salt. Each ampule contains more than 1 cc. PHENOLTETRACHLORPHTHALEIN-H. W. & D. — Phenoltetrachlorphthaleinum. — A dibasic dye formed by the condensation of phenol and tetrachlorphthalic acid or its anhydride. Actions and Uses. — Phenoltetrachlorphthalein has been used for the determination of the functional activity of the liver. It can be used, in the form of the sodium salt, intravenously ; it cannot be given subcutaneously or intramuscularly. It has been proposed that the excretion can be determined by any one of these methods : 1. The excretion of the drug in the stool: Rowntree, Hur- witz and Bloomfield (Bull. Johns Hopkins Hosp. 24:327, 1913) ; Whipple, Peightal and Clark {Bull. Johns Hopkins Hosp. 24: 343, 1913) ; Rowntree, Marshall and Chesney (Proc. Am. A. Phys. & Surg., 1914; /. A. M. A. 63:1533 [Oct. 31] 1914). 2. The excretion of the drug in the duodenum by means of a duodenal tube: Aaron, Beck and Schneider (/. A. M. A., Nov. 19, 1921, p. 1631). 3. Its disappearance from the blood stream : S. M. Rosenthal (/. Pharmacol. & Exper. Therap. 19:385 [June] 1922) ; H. H. Rosenfield and E. F, Schneiders (/. A. M, A„ March 17, 1923, p. 743), DYES 207 Dosage. — From 0.05 to 0.4 Gm. administered in the form of the disodium salt. The solution must not be exposed unduly long, as the salt is sensitive to the action of the carbon dioxide of the atmosphere. Manufactured by Hynson, Westcott & Dunning, Baltimore. No U. S. patent or trademark. Ampules Phenoltetrachlorphthalein-H. IV. & D.: Each ampule contains more than 2 cc. of a solution of disodium phenoltetrachlorphthalein, each cubic centimeter representing 0.05 Gm. of phenoltetrachlorphthalein- H. W. & D. Phenoltetrachlorphthalein-H. W. & D. is a cream white powder; odorless; permanent in the air. It is practically insoluble in water; very soluble in acetone, soluble in alcohol, ether and glacial acetic acid; slightly soluble in chloroform, benzene and carbon disulfide. It dissolves in solutions of the alkalis and carbonates to form solutions which are deep purple when concentrated, but which change to violet- red on dilution, and in very dilute solutions assume a bluish tint (distinction from phenolphthalein). Phenoltetrachlorphthalein does not melt when heated to 300 C. It does not respond to the U. S. P. test for heavy metals as described under phenolphthalein. Dry about 1 Gm. of phenoltetrachlorphthalein-H. W. & D., accu- rately weighed, to constant weight at 115 C.: the loss is not more than 0.5 per cent. To about 5 Gm. of the substance, accurately weighed, add 25 cc. of normal sodium hydroxide solution, heat to about 70 C. and stir. Dilute with warm water to about 75 cc, filter through a tared Gooch crucible, dry to constant weight at 115 C. and weigh: the weight of the insoluble matter (tetrachlorfluorane) does not exceed 0.2 per cent. Incinerate about 2 Gm. of the substance, accu- rately weighed: the ash does not exceed 0.15 per cent. PHENTETIOTHALEIN SODIUM. — Phentetiotha- leinis Sodium. — Phenoltetraiodophthalein Sodium. — NaO.O : I 1 C.CeL.C : CeH^OCeHiONa. The sodium salt of a dibasic dye, phenoltetraiodophthalein. Phentetiothalein sodium contains from 56 per cent to 59 per cent of iodine. Actions and Uses. — Phentetiothalein sodium is used for the roentgenologic examination of the gallbladder and simultaneous test of hepatic function. It is said to be better suited for intravenous injection than tetiothalein sodium, because the dosage is smaller and better tolerated, and because one injection serves at the same time for cholecystography and liver function test. Following the intravenous injection, the solution appears in the normal gallbladder in sufficient concentration to cast a shadow to the roentgen rays and if the liver is damaged it is retained in the blood in amounts indicative of the extent of impairment. It is claimed to cause little or no toxic reaction. Myocardial insufficiency and uremia are considered contra- indications, and jaundice enjoins caution. Dosage. — Intravenously for visualization of the gallbladder and simultaneous test of liver function, 40 mg, per kilogram of body weight ; the dose need not exceed 2.5 Gm., regardless of weight. The dye is dissolved in freshly distilled water, filtered through fine filter paper, and sterilized for fifteen min- 208 NEW AND NONOFFICIAL REMEDIES utes in a boiling water bath. A solution of 8 per cent has been found satisfactory. The solution is injected intravenously by gravity or syringe method, either in the morning between 8 and 9 or in the evening between 5 and 9. If given in the evening the evening meal should be omitted and no food given until the first roentgenogram is taken in the morning. At this time a fat meal is given and the roentgenogram taken one hour after the meal and, if desired, another three hours after the meal to determine the rapidity and characteristics of emptying. More satisfactory results are probably obtained if the injection is made in the morning with the stomach empty, omitting breakfast and lunch and taking roentgenograms four, eight and twenty-four hours after the injection. For gallbladder visual- ization alone the drug is administered orally : 4 Gm. in the form of plain gelatin capsules (8 capsules of 0.5 Gm, each), or dissolved in 30 cc. of distilled water and added to 120 to 240 cc. of grape juice, to be taken during and after the evening meal, which should be of the usual amount but free of fat (the aqueous solution of the drug should not be more than 48 hours old). Meticulous roentgen ray technic is necessary, and if the interpretation of the cholecystogram is in question a check determination should be made either by the oral or, if preferred, by the intravenous method. The liver function test cannot be made by this method because the dye is not absorbed rapidly enough into the blood. To make the determination of liver function, blood is collected one-half hour and again preferably one hour after the intra- venous injection. The serum is alkalinized with a small drop of 5 per cent solution of sodium hydroxide and compared to a set of standard solutions as suggested by Rosenthal (An Improved Method for Using Phenoltetrachlorphthalein as a Liver Func- tion Test, /. Pharmacol. & Exper. Therap. 19:385 [June] 1922) and modified by Cole, Gopher and Graham (Simultaneous Cholecystography and Determination of Liver Function, /. A. M. ^. 90:1111 [April 7] 1928. Phentetiothalein sodium occurs as bronze purple, odorless, slightly hygroscopic granules. It is soluble in water and alcohol. Dissolve 1 Gm._ of phentetiothalein sodium in water: a clear solution appears. Add diluted hydrochloric acid drop by drop to 1 cc. of a 10 per cent aqueous solution of phentetiothalein sodium: a yellow colored precipitate appears. Add sodium hydroxide solution in large excess to 1 cc. of a 10 per cent aqueous solution of phentetiothalein sodium: a permanent purple color appears. Intimately mix 0.1 Gm. of the_ salt with 1.0 Gm. of anhydrous sodium carbonate and heat to fusion; cool the mixture, dissolve in diluted hydrochloric acid and filter; add a few drops of hydrogen peroxide solution and agitate the mixture with a few cubic centimeters of chloroform: the chloroform layer is colored violet {iodine). Transfer about 0.5 Gm., accurately weighed, of phentetiothalein sodium to a flat type weighing bottle and dry in a vacuum at 80 C. to constant weight: the loss in weight is not more than 5 per cent. Transfer about 0.2 Gm., accurately weighed, of phentetiothalein sodium to a bomb tube; determine the iodine by the Carius method: the amount of iodine found is not less than 56 per cent nor more than 59 per cent when calculated to the dry basis. DYES 209 Iso-Iodeikon. — A brand of phentetiothalein sodium-N. N. R. Manufactured by the Mallinckrodt Chemical Works, St. Louis. No U. S. patent or trademark. Iso-Iodeikon, 2.5 Gm. Ampoules. SOLUBLE lODOPHTHALEIN.— Tetraiodophenolphtha- lein Sodium. — Tetraiodophthalein Sodium. — Tetiothalein Sodium. — "The disodium salt of tetraiodophenolphthalein. It contains not less than 85 per cent of tetraiodophenolphthalein. The separated tetraiodophenolphthalein contains not less than 61 per cent and not more than 62 per cent of I." U. S. P. For standards see the U. S. Pharmacopeia under lodo- phthaleinum Solubile. Actions and Uses. — Soluble iodophthalein is used for the roent- genologic examination of the gallbladder. Following the intra- venous injection or, if decomposition is avoided, the oral administration, the substance appears in the normal gallbladder in sufficient concentration to cast a shadow to the roentgen rays. After injection, a few of the patients may have unpleasant sen- sations, such as dizziness, nausea, various body pains, and fall in blood pressure. The transitory fall in blood pressure may be relieved by the administration of from 0.5 to 1 cc. of epinephrine hydrochloride solution (1 in 1,000) intramuscularly. Soluble iodophthalein is useful as a diagnostic agent, but workers are cautioned as to the selection of types of cases in which it is indicated and its possible toxicity in large doses. More than 1,000 patients, however, are reported to have been examined by this method with no deaths. Myocardial insufficiency and uremia are considered contraindications, and jaundice enjoins caution. Dosage. — To visualize the gallbladder in a patient weighing between 115 and 160 pounds (52 and 72.6 Kg.), 3 Gm. of soluble iodophthalein is dissolved in 24 cc, or 3.5 Gm. of soluble iodophthalein is dissolved in 28 cc. of freshly distilled water ; the solution is then sterilized by heating the container in boiling water for twenty minutes. For patients weighing over 160 pounds the maximum dose should not exceed 3.5 Gm. For patients weighing less than 115 pounds (52 Kg.), the amount of salt is to be reduced. The solution is injected intravenously in two doses, one-half hour apart, in the morning before breakfast. Care must be taken not to allow extravasation, in order to avoid tissue necrosis. Breakfast is omitted. At noon a glass of milk is permitted, and the evening meal is allowed as usual. Water by mouth is allowed at all times. Soluble iodophthalein may be administered orally: 4 Gm. in the form of plain gelatin capsules (8 capsules of 0.5 Gm. each), or dissolved in 30 cc. of distilled water and added to 120 to 240 cc. of grape juice, to be taken during and after the evening meal, which should be of the usual amount but free of fat (the aqueous solution of the drug should not be more than 48 210 NEW AND NONOFFICIAL REMEDIES hours old). Keratin coated capsules may be used. Meticulous roentgen technic is necessary, and if the interpretation of the cholecystogram is in question a control determination should be made either by the oral or, if preferred, by the intravenous method. Soluble iodophthalein is said to be preferable for intravenous injection. lodeikon. — A brand of soluble iodophthalein-U. S. P. Manufactured by the Mallinckrodt Chemical Works, St. Louis. No U. S. patent. U. S. trademark 222,470. lodeikon, 3.5 Gin. Ampules. lodeikon Capsules-Abbott. — Each keratin-coated capsule contains iodei- kon, 0.25 Gm. Prepared by the Abbott Laboratories, North Chicago, 111. Tetraiodophenolphthalein Sodium Salt-Eastman. — A brand of soluble iodophthalein-U, S. P. Manufactured by the Eastman Kodak Company, Rochester, N. Y. No U. S. patent or trademark. The Triphenylmethane (Rosaniline) Dyes Of the derivatives of triphenylmethane and its homologue tolyldiphenylmethane, the most interesting medicinally are those which result from the introduction of amino groups forming pararosaniline (triaminotriphenylcarbinol (NH2C6H4)3COH) and rosaniline (triaminotriphenyltolycarbinol (NH2C6H4)2(CH3. NH2CeH3).COH). On treating rosaniline with hydrochloric acid, the hydroxyl of the carbinol group is split off, permitting the formation of a quinoid group ; thus is formed a typical dye known as fuchsin, NH.CeH..CH3.NH2C0H3C:C6H4:NH2Cl. The red color of pararosaniline chloride or fuchsin is changed to violet by the entrance of a methyl group in the amino groups, the intensity of the violet color increasing with an increasing number of methyl groups. Thus, there are the closely related gentian violet, crystal violet and methyl violet. Gentian violet is a mixture of pentamethylpararosaniline chloride and hexa- methylpararosaniline chloride ; by some it is defined as a mixture of methyl violet and crystal violet. Crystal violet is a relatively pure form of hexamethylpararosaniline chloride; methyl violet is considered to contain mostly pentamethylpararosaniline chlor- ide with some of the hexaderivative and probably some tetra- derivative also. Hence, one definition of gentian violet is prac- tically the same as the other. It seems likely that in therapeutics it will be found that there is little difference between the penta and hexa derivatives and the mixtures of the two, so that the one most easily obtained in pure form (crystal violet) will be the one most used. The material which has been used by the workers so far, however, has been gentian violet. Actions and Uses. — Gentian violet was introduced as an antiseptic by J. Stelling in 1890 and has recently been advocated by Churchman, who found that solutions of the dye had a DYES 211 selective action on certain bacteria and that the majority of gram-negative organisms survived exposure to gentian violet solutions in strengths far in excess of that required to kill gram-positive organisms ; in fact, the action of the dye is sufficiently selective, so that often a "strain within a species" is not affected. Churchman's work, however, was done largely with a product containing dextrin as a diluent. Gentian violet is a useful antiseptic for infected wounds, mucous membranes and serous surfaces. Its chief application has been in the treat- ment of affections of the pleural cavity and of the joints, particularly in empyema and arthritis — affections in which staphylococci, B. pyocyaneus and B. diphtheriae are the causa- tive agents. Young and Hill have also proposed the use of gentian violet intravenously in staphylococcus septicemia, chronic cystitis (from staphylococcus), osteomyelitis (with staphylococcus present). The effects are probably due to fioc- culation and colloidal "reactions," which are not without danger. Intravenous injection of the dye in doses of 5 mg. per kilogram of body weight causes marked cyanosis, which persists for a few hours after injection, owing to the intense color of the dye. In feeble patients, cardiac stimulants should be given. Evidence has been advanced that gentian violet, administered in enteric coated tablets, is of value as an anthelmintic in the treatment of Strongloides infection. Churchman also has found that acid fuchsin (the acid sodium salt of fuchsin disulfonic and trisulfonic acids) is in some respects the opposite of that of gentian violet in selective power, a stained culture of B. prodigiosus being killed by the acid fuchsin, while the gram positive B. anthracis would be unaffected. The selec- tive action of acid fuchsin, however, is clearly brought out only when the organisms are exposed to the dye with slight elevation of temperature (about 50 C). Acid fuchsin is incompatible with gentian violet, and the compatibility of all mixtures of dyes should be determined before any combination is prepared. Churchman claims, however, that acriflavine possesses much the same selectivity as acid fuchsin, so he has proposed the use of a mixture of these two dyes. The effectiveness of such a solution has not yet been established clinically. None of the rosaniline dyes is a strong bactericide. CRYSTAL VIOLET. — Hexamethyltriamino-triphenyl- methane. — Hexamethylpararosaniline chloride. — (CH3)2N.C6H4. (CH3)2N.C6H4.C : CcH^ : N.(CH3)2C1. Actions and Uses. — See preceding article, The Triphenyl- methane (Rosaniline) Dyes. Dosage. — For direct application, a solution of from 1 in 500 to 1 in 1,000 may be employed. For the treatment of burns, local applications in the form of a spray or jelly containing 1 per cent of crystal violet have been employed. Crystal violet occurs as a dark green amorphous powder having a light metallic luster. It is soluble in alcohol, chloroform, glycerin and water, practically insoluble in benzene and ether. 212 NEW AND NONOFFICIAL REMEDIES Reduce about 0.2 Gm. of crystal violet with zinc and diluted hydro- chloric acid until colorless, filter through paper: no immediate colora- tion occurs, but a blue zone appears at point of contact when the solu- tion is spotted with ammonia water. When tested for arsenic according to U. S. P. XI, the product should meet the requirements for arsenic (p. 438, Arsenic Test). To about 1 Gm. of crystal violet previously ignited in a platinum dish with an excess of sulfuric acid, add 5 cc. of hydrochloric acid and evaporate to dryness, treat the residue obtained with 20 cc. of a diluted hydro- chloric acid (1 part of acid and 20 parts of water), warm, filter through paper and divide into two portions: a faint precipitate occurs on satura- ation with hydrogen sulfide {heavy metals); no precipitation on the addition of 1 cc. of potassium ferrocyanide solution {zinc). Dry about 1 Gm. of crystal violet, accurately weighed, to constant weight at 100 C. : the loss does not exceed 2.5 per cent. Incinerate about 1 Gm. of crystal violet, accurately weighed, previously dried at 100 C.: the ash does not exceed 1 per cent. Dissolve about 1 Gm. of crystal violet, previously dried at 100 C., in 300 cc. of alcohol, heat to boiling; collect the insoluble matter, if any, in a tared Gooch crucible; wash the insoluble matter with hot alcohol, dry the insoluble matter to constant weight at 100 C.: the insoluble matter does not exceed 0.1 per cent. Transfer about 0.5 Gm. of crystal violet to a 500 cc. Kjeldahl flask and determine the nitrogen content according to the official method described in Official and Tentative Methods of Analysis of the Association of Official Agricultural Chemists, third edition, page 20, chapter 2, paragraph 22: the percentage of nitrogen corresponds to not less than 10 per cent, nor more than 11 per cent when calculated to the dried substance. Transfer about 0.5 Gm. of crystal violet to a Parr sulfur bomb; determine the chlorine content by the Parr method: the amount of chlorine found corresponds to not less than 8.4 per cent nor more than 8.9 per cent when calculated to the dried substance. Dissolve about 5 Gm. of crystal violet, accurately weighed, in 400 cc. of water, previously boiled, cool under carbon dioxide and make up to a 500 cc. volume in a volumetric flask; transfer an aliquot of 50 cc. to a mixture of 20 cc. alcohol, 10 cc. glacial acetic acid, 50 cc. of a 20 per cent solution of potassium and sodium tartrate and 50 cc. of water, and while continually boiling titrate with tenth-normal titanium trichloride solution: the percentage of purity (using factor 0.020386) corresponds to not less than 96 per cent nor more than 100 per cent when calculated to the dried substance. Crystal Violet Medicinal-Calco.— A brand of crystal violet-N. N. R. Manufactured by the Calco Chemical Co., Inc., Bound Brook, N. J. No U. S. patent or trademark. Crystal Violet Jelly-Calco: A 1 per cent aqueous solution of crystal violet-N. N. R. in a gum tragacanth jelly base. • GENTIAN VIOLET MEDICINAL.— A mixture of pentamethylpararosaniline and hexamethylpararosaniline chlor- ides. Actions and Uses. — See preceding article, The Triphenyl- methane (Rosaniline) Dyes. Dosage. — For direct application, a solution of from 1 in 500 to 1 in 1,000 may be employed; for instillation, a 1 in 10,000 solution. For intravenous use, Young and Hill recommend 5 mg. per kilogram of body weight, injected in 0.5 per cent dilution. For Strongloides infection, 0.03 Gm. Gentian violet occurs as a dark green ("bronze") powder or greenish glistening pieces having a metallic luster. It is soluble in water (1 in 10), alcohol or chloroform; insoluble in ether. Its solution in alcohol or chloroform has a deeper hue than the same strength aqueous solution. BENZEDRINE 213 Concentrated sulfuric acid dissolves gentian violet \yith an orange to brownish-red color; on slowly diluting this solution in distilled water, the solution assumes a brown, then a green and finally a blue color. Add, drop by drop, tannic acid solution to a solution of gentian violet (1 in 500): a deep blue precipitate forms (basic color). To 5 cc. of an aqueous solution of gentian violet, add a few drops of hydro- chloric acid and about 0.5 Gm. of zinc dust; rapid decolorization ensues. Place a few drops of the decolorized solution near a few drops of ammonia water on filter paper: the zone of contact assumes a blue color. Add hydrochloric acid slowly, drop by drop, with agitation to an aqueous solution of the dye (1 in 500): the violet color changes gradually to bluish-green, to green and finally to brownish-yellow, the solution remaining clear; now dilute gradually the solution: the color changes in reverse order as the hydrogen-ion concentration is increased. Dissolve 1 Gm. of the dye in boiling alcohol; cool; filter through Gooch filter; wash residue with alcohol until washings cease to be colored violet and dry at 100 C.: the weight of insoluble material corresponds to not more than 1 per cent (dextrin). When tested for arsenic according to the U. S. Pharmacopeia, X, the product should meet requirements for the test for arsenic (p. 428, Arsenic Test). Incinerate 1 Gm. of gentian violet: not more than 0.01 Gm. of ash remains. Gentian Violet Improved Medicinal. — A brand of gentian violet medicinal-N. N. R. Manufactured by The Coleman and Bell Company, Norwood, Ohio. No U. S. patent or trademark. Gentian Violet Medicinal-"National." — A brand of gen- tian violet medicinal-N. N. R. Manufactured by The National Aniline and Chemical Company, Inc., New York. No U. S. patent or trademark. Tablets Gentian Violet Medicinal-" National," 0.0324 Gm. (Y2 grain). Enteric Coated Tablets Gentian Violet Medicinal-" National," 0.0324.Gm (^2 grain): The tablets are coated with phenyl salicylate containing some keratin. EPINEPHRINE AND RELATED PREPARATIONS Phenylalkylamine Derivatives Benzedrine BENZEDRINE. — Racemicdesoxy-nor-ephedrine. — Racemic benzyl-methyl carbinamine. — A synthetically prepared racemic mixture of bases having the formula C6H5CH2CHNH2CH3. Actions and Uses. — Benzedrine produces local effects similar to those of ephedrine. Local application, by means of a spray or dropper, of a 1 per cent solution in liquid petrolatum, or inhalation of the vapors of benzedrine or its carbonate produces shrinking of the nasal mucosa in head colds, sinusitis, vaso- motor rhinitis, hay fever and asthma. Both benzedrine and its carbonate (the latter readily forms on exposure of benzedrine to air) are volatile. 214 NEW AND NONOFFICIAL REMEDIES Dosage. — As a spray, a 1 per cent solution in liquid petro- latum ; as an inhalant, one or two inhalations through each nostril at hourly intervals, has been recommended. Continued overdosage should be guarded against, as this has caused rest- lessness and sleeplessness ; but no serious reactions have been observed. Manufactured by Smith, Kline & French Laboratories, Philadelphia, Pa. U. S. patent 1,921,424 (Aug. 8, 1933; expires 1950) 1,879,003 (Sept. 27, 1932; expires 1949) and 2,015,408 (Sept. 24, 1935; expires 1952). U. S. trademark 272.377. Benzedrine Inhaler: Each inhaler tube contains, at the time of packing, benzedrine 0.325 Gm., oil of lavender 0.097 Gm., and menthol 0.032 Gm. Benzedrine Solution: Benzedrine 1 per cent, oil of lavender 0.33 per cent, in liquid petrolatum. Benzedrine occurs as a colorless, mobile liquid, boiling at 200-203 C, with slight decomposition. The specific gravity at 25 C. is 0.931. The vapor pressure at ordinary temperature is relatively high, and the substance possesses a strong basic odor and a burning taste. It is soluble in ether and alcohol and slightly soluble in water. Place 1 Gm. of benzedrine in an Erlenmeyer flask, add 50 cc. of water and 5 cc. of 40 per cent sodium hydroxide solution, then add benzoyl chloride, 0.5 cc. at a time; shake the flask after each addition; add the benzoyl chloride until no more precipitate forms after an addi- tion. Recrystallize twice from 50 per cent alcohol solution, dry the crystals; the melting point is 134-135 C. The nitrogen content of the benzoyl derivative by the micro Dumas method is not less than 5.70 nor more than 5.95 per cent. Transfer 0.5 Gm. of benzedrine, accurately weighed, to a tared weighing bottle and place on the steam bath for one hour. The residue is not more than 0.5 per cent (nonvolatile compounds). Dissolve 1 cc. of benzedrine in 10 cc. of liquid petrolatum U. S. P. X (anhydrous): no turbidity is produced (water). Suspend about 1 Gm. of benzedrine, accurately weighed, in 10 cc. of water and titrate with half-normal sulfuric acid, using methyl red as an indicator: the acid used corresponds to not less than 95 per cent nor more than 100 per cent of the base (1 cc. half -normal sulfuric acid is equivalent to 0.0675 Gm. of base). Determine carbon, hydrogen and nitrogen by micro combustion methods. The carbon should be not less than 79.7 nor more than 80.2 per cent; the hydrogen, not less than 9.6 nor more than 9.9 per cent; and the nitrogen, not less than 10.2 nor more than 10.6 per cent. Benzedrine Inhaler: Transfer the cotton filling to a Kjeldahl distilla- tion flask, add 250 cc. of water and 1 Gm. of_ sodium hydroxide; distil 150 cc. into 20 cc. of tenth-normal sulfuric acid, titrate the excess acid with tenth-normal sodium hydroxide solution: the base is equivalent to not less than 0.305 Gm. nor more than 0.360 Gm. per tube. Transfer the solution from the titration to a separatory funnel, extract with 30 cc. of ether, transfer the aqueous layer to an Erlenmeyer flask, add 2 cc. of 40 per cent sodium hydroxide solution and 0.5 cc. of benzoyl chloride and shake the flask and contents for ten minutes; set aside for two hours; add 0.5 cc. of benzoyl chloride, shake the flask and contents for ten minutes, set aside; at the end of two hours add 0.5 cc. of benzoyl chloride, shake the flask for ten minutes, allow to stand on the steam bath until the odor of benzoyl chloride has dis- appeared; remove the precipitate by filtration, wash with cold water, dry at 90 C.; the melting point is 130-135 C. Benzedrine Solution: Transfer an accurately weighed sarnpleof benze- drine solution weighing about 15 Gm. to a Kjeldahl distillation flask, add 5 Gm. of talc, 250 cc. of water and 1 Gm. of sodium hydroxide; distil 150 cc. into 20 cc. of tenth-normal sulfuric acid, titrate the excess acid with tenth-normal sodium hydroxide solution: the base is equivalent to not less than 0.95 per cent nor more than 1.05 per cent. Transfer the foregoing solution to a separatory funnel and proceed to determine the melting point of benzoyl derivative as outlined under "Benzedrine Inhaler." EPHEDRINE 215 Ephedrine Ephedrine is an alkaloid first obtained by Nagai in 1887 from a Chinese herb, ma huang (Ephedra eqiiisetina). Chemically, ephedrine is a-hydroxy-/3-methylamino-propylbenzene (CeHs. CHOH.CH(NHCH3).CH3). Structurally, it is closely related to epinephrine, and like epinephrine it is levorotatory ; but it is more stable. Its salts are, in general, soluble in water and in alcohol. Actions and Uses. — Ephedrine produces effects somewhat similar to those of epinephrine. However, it is difficult to explain its actions without postulating a direct stimulation of smooth muscle as well as a stimulating effect on the sympa- thetic nervous system. In small doses ephedrine has a stimu- lating action upon the heart, increasing the rate and the strength of contractions and raising the blood pressure. In large and toxic doses the drug has a depressant action upon the heart muscle. It causes a rather lasting rise of blood pressure, on intravenous or intramuscular injection, due mainly to vasoconstriction. Other effects similar to those of epineph- rine are dilatation of the bronchi and mydriasis after local or systematic administration. On local application to mucous mem- branes or wounds it contracts the capillaries to a moderate degree and thus diminishes hyperemia and reduces swelling. Ephedrine is used locally in the eye to dilate the pupils, and in the nostrils to shrink the congested mucosa in rhinitis and sinu- sitis. The systemic effects can be obtained by oral as well as by hypodermic or intramuscular administration. Ephedrine is useful against asthma, especially to prevent the attacks ; but it often fails partially or completely. It is also used against hay fever and urticaria. It tends to produce symptoms of the anxiety complex. This may constitute a definite contraindica- tion to its use. Its use in serious heart disease is not yet con- sidered safe. Ephedrine is used to sustain the blood pressure in spinal anesthesia, but it is still questionable whether the drug is of real benefit in shock, hypotension and circulatory collapse and hemorrhage. It is without value in Addison's disease. Dosage. — Salts of ephedrine are quite effective whether given orally, intramuscularly, intravenously, or by any ordinary path of administration. As a spray it is used in 0.5 to 2 per cent solution of a salt of ephedrine ; in ophthalmologic work it has been used in 4 per cent solution. Orally, the usual dose for adults is from 20 to 50 mg. (Ys to % grain) every 3 to 4 hours. EPHEDRINE. — "An alkaloid obtained from Ephedra eqiiisetina Bunge, Ephedra sinica Stapf and other species of Ephedra (Fam. Gnetaceae)." U. S. P. For standards see the U. S. Pharmacopeia under Ephedrina. 216 NEW AND NONOFFICIAL REMEDIES Actions and Uses. — The same as those of the ephedrine salts. The free alkaloid is employed in mediums, such as oils, in which it is more soluble than the salts. _ Dosage. — One per cent, in oil, may be used for local applica- tion to mucous membranes. Orally, the usual dose for adults is from 20 to 50 mg. (^ to % grain) every 3 to 4 hours. Ephedrine-Abbott. — A brand of ephedrine-U. S. P. Manufactured by the Abbott Laboratories, North Chicago, 111. No U. S. patent or trademark. Ephedrine Inhalant-Abbott: A 1 per cent solution of ephedrine- Abbott in light liquid petrolatum tinted pink and perfumed with oil of rose. No U. S. trademark. Ephedrine-Lilly. — A brand of ephedrine-U. S. P. Manufactured by Eli Lilly & Company, Indianapolis. No U. S. patent or trademark. Inhalant Ephedrine Compound-Lilly: A solution containing ephedrine- Lilly, 1 Gm. in a liquid composed of menthol, 0.66 Gm. ; camphor, 0.66 Gm.; oil of thyme, 0.31 cc. ; liquid petrolatum to make 100 cc. U. S. patent 1,743,992 (Jan. 14, 1930; expires 1947) and 1,762,128 (June 3, 1930; expires 1947). No U. S. trademark. Inhalant Ephedrine ( Plain) -Lilly : A solution made by dissolving ephedrine base, 1 Gm., in cottonseed oil and perfuming and flavoring with cinnamic aldehyde, benzaldehyde and jasmine extract tinted with butter yellow. Sufficient liquid petrolatum is then added to make 100 cc. The product does not, however, contain ephedrine base, which reacts with the aldehydes; the finished substance contains ephedrine cinnamic aldehyde, 0.85 Gm., and ephedrine benzaldehyde, 0.88 Gm., in each 100 cc. of inhalant. Ointment Ephedrine Co-mpaund: Ephedrine-Lilly, 1 Gm.; menthol, 0.65 Gm.; camphor, 0.65 Gm., oil of thyme, 0.375 Gm.; hydrous wool fat, 5 Gm.; liquid petrolatum, 24 Gm.; white petrolatum to make 100 Gm. EPHEDRINE ANHYDROUS.— Ephedrina Sicca.— /a^z;o-ct-hydroxy-j8-methyl-amino-propylbenzene. — (CeHo.CHOH. CHNHCH3CH3). An alkaloid derived from Ephedra equisetina. Actions and Uses. — The same as those of the ephedrine salts. The free alkaloid is employed in mediums, such as oils, in which it is more soluble than the salts. Dosage. — One per cent, in oil, may be used for local applica- tion to mucous membranes. Ephedrine anhydrous occurs as an unctuous, almost colorless solid that tends to crystallize as needles. The liquefied alkaloid boils between 152 and 153 C. at 25 mm. pressure. It is freely soluble in alcohol, chloroform and ether, and soluble in liquid petrolatum and water, the solutions being strongly alkaline to litmus paper moistened with water. Dissolve 0.01 Gm. of ephedrine anhydrous in 1 cc. of water and add 0.1 cc. of copper sulfate solution (10 per cent) followed by 1 cc. of sodium hydroxide solution (20 per cent) : a reddish purple color develops. To this solution add 1 cc. of ether, shake the mixture and compare with a tube made up similarly, but without using ether: the reddish purple is partially extracted (apparently^ decolorized by the ether). Dissolve 0.05 Gm. of ephedrine anhydrous in 10 cc. of chloro- form and allow the solution to stand for 18 hours, evaporate sponta- neously: white crystals of ephedrine hydrochloride appear; wash with 2 cc. of chloroform, dry spontaneously: the crystals melt at 214-220 C. Dissolve 0.05 Gm. of ephedrine anhydrous in from 30 to 40 cc. of distilled water, add 1 cc. of diluted nitric acid and 1 cc. of silver EPHEDRINE ' 217 nitrate solution : less turbidity results than in a control tube using 0.1 cc. of fiftieth-normal hydrochloric acid (limit of chloride). Dis- solve 0.1 Gm. of ephedrine anhydrous in from 30 to 40 cc. of distilled water, add 1 cc. of diluted hydrochloric acid and 1 cc. of barium chloride solution: no turbidity develops in ten minutes (limit of sulfate). Transfer about 1 Gm. of ephedrine anhydrous, accurately weighed, to a 10 cc. graduated flask and dissolve by adding 7 cc. of water and 1 cc. of hydrochloric acid; dilute the solution to 10 cc, transfer the solution to a polarimetric tube and take the rotation at 25 C: the specific rotation [a] 25/D of the hydrochloride falls between — 33.0 and — 35.5. (The factor ephedrine to ephedrine hydrochloride is 1.22. The weight of the hydrochloride should be corrected for the water in the ephedrine by dividing the calculated weight by the percentage of ephedrine obtained in the titration.) Dissolve about 0.2 Gm. of ephedrine anhydrous, accurately weighed, in 5 cc. of neutralized alcohol, add 5 drops of bromcresol green solution and an excess of tenth-normal hydrochloric acid and titrate the excess, using tenth-normal sodium hydroxide solution: the acid used in neutralizing the ephedrine is equivalent to not less than 98 per cent nor more than 100 per cent of ephedrine anhydrous. Dissolve about 0.2 Gm. of ephedrine anhydrous, accurately weighed, in a tared beaker in 10 cc. of absolute ether; evaporate spontaneously; dry the residue for 18 hours in a desiccator containing calcium chloride and ephedrine, the temperature not being allowed to exceed 22 C: the loss is not greater than 1.5 per cent. Fit a 100 cc. beaker with a cork stopper through which has been inserted a test tube 2J4 inches long and nine-sixteenths inch in diameter; remove the stopper and accompanying test tube from the beaker; transfer 5 Gm. of ephedrine anhydrous to the test tube; melt the material by immersing the test tube in hot water; cool the test tube and contents to about 30 C. ; place the stopper and test tube in the beaker; stir slowly the supercooled liquid, using an appropriate Anschutz thermometer; record the highest temperature obtained as the material congeals: the congealing point is between 31.0 and 37.5 C. Heat about 0.5 Gm. of ephedrine anhydrous, accurately weighed, in a platinum dish until constant weight is obtained: the ash is less than 0.1 per cent. EPHEDRINE HEMIHYDRATE. — Ephedrina Semi- aquosa. — /a^z/o-a-hydroxy-/3-methyl-amino-propylbenzene with one-half molecule of water of crystalHzation. QHoCHOH.CH NHCHs.CHs.^^HaO. A hydrated alkaloid derived from Ephedra eqtdsetina. Actions and Uses. — The same as those of the ephedrine salts. The free^ alkaloid is employed in mediums, such as oils, in which it is more soluble than the salts. Dosage. — One per cent, in a suitable base, may be used for local application to mucous membranes. Ephedrine hemihydrate occurs as colorless hexagonal plates. The liquefied alkaloid boils at 152-153 C. at 25 mm. pressure. It is freely soluble in alcohol, ether and chloroform (the chloroform solution is turbid, owing to the insolubility of the accompanying water). It is soluble in water. All of these solutions are strongly alkaline to litmus paper moistened with water. It is soluble in liquid petrolatum but the solution is turbid, owing to the insolubility of the accompany- ing water. Dissolve 0.01 Gm. of ephedrine hemihydrate in 1 cc. of water and add 0.1 cc. _ of copper sulfate solution (10 per cent) followed by 1 cc. of sodium hydroxide solution (20 per cent) : a reddish purple color develops. To this solution add 1 cc. of ether, shake the mixture 218 NEW AND NONOFFICIAL REMEDIES and compare with a tube made up similarly, but without using ether: the reddish purple is partially extracted (apparently decolorized by the ether). Dissolve 0.05 Gm. of ephedrine hemihydrate in 10 cc. of chloroform, and allow the solution to stand 18 hours, evaporate the chloroform spontaneously: white crystals of ephedrine hydrochloride appear; wash with 2 cc. of chloroform, dry spontaneously: the crystals melt at 214-220 C. Dissolve 0.05 Gm. of ephedrine hemihydrate in from 30 to 40 cc. of distilled water, add 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution: less turbidity results than in a control tube con- taining the same quantity of reagents, to which has been added 0.1 cc. of fiftieth-normal hydrochloric acid {limit of chloride). Dissolve 0.1 Gm. of ephedrine hemihydrate in from 30 to 40 cc. of distilled water, add 1 cc. of diluted hydrochloric acid and 1 cc. of barium chloride solution: no turbidity develops in 10 minutes (limit of sulfate). Transfer about 1 Gm. of ephedrine hemihydrate, accurately weighed, to a 10 cc. graduated flask and dissolve by adding 7 cc. of water and 1 cc. of hydrochloric acid; dilute the solution to 10 cc. transfer the Eolution to a polarimetric tube and take the rotation at 25 C.: the specific rotation [a] 25/D of the hydrochloride falls between — 33.0 and — 35.5. (The factor ephedrine to ephedrine hydrochloride is 1.22. The weight of the hydrochloride should be corrected for the water in the ephedrine by dividing the calculated weight by the per- centage of ephedrine obtained in the titration). Dissolve about 0.2 Gm. of ephedrine hemihydrate, accurately weighed, in 5 cc. of neutralized alcohol, add 5 drops of bromcresol green solu- tion and an excess of tenth-normal hydrochloric acid and titrate the excess, using tenth-normal sodium hydroxide solution: the acid used in neutralizing the ephedrine is equivalent to not less than 94 per cent nor more than 96 per cent of ephedrine. Dissolve about 0.2 Gm. of ephedrine hemihydrate, accurately weighed, in a tared beaker in 10 cc. of absolute ether, evaporate spontaneously; dry the residue for 18 hours in a desiccator containing calcium chloride and ephedrine, the temperature not being allowed to exceed 22 C. : the loss is not greater than 6 per cent nor less than 3 per cent. Fit a 100 cc. beaker with a cork stopper through which has been inserted a test tube 2^ inches long and nine-sixteenths inch in diameter; remove the stopper and accompanying test tube from the beaker; transfer 5 Gm. of ephedrine hemihydrate to the test tube, melt the material by immersing the test tube in hot water, cool the test tube and contents to about 30 C, place the stopper and test tube in the beaker; stir the supercooled liquid slowly, using an appropriate Anschutz thermometer; record the highest temperature obtained as the material congeals; the congealing point is between 36 and 39.4 C. Heat about 0.5 Gm. of ephedrine hemihydrate, accurately weighed, in a platinum dish until constant weight is obtained: the ash is less than 0.1 per cent. Ephedrine Alkaloid-Merck. — A brand of ephedrine hemi- hydrate-N. N. R. Manufactured by Merck & Co., Inc., Rahway, N. J. No U. S. patent or trademark. EPHEDRINE HYDROCHLORIDE.— "When dried over sulfuric acid for twenty-four hours, contains not less than 80 per cent and not more than 82.5 per cent of anhydrous eohedrine (C10H15ON)." U. S. P. For standards see the U. S. Pharmacopeia under Ephedrinae Hydrochloridum. Actions and Uses. — See preceding article, Ephedrine. Dosage. — See preceding article, Ephedrine. EPHEDRINE 219 Ephedrine Hydrochloride-Abbott. — A brand of ephedrine hydrochloride-U. S. P. Manufactured by the Abbott Laboratories, North Chicago, 111. No U. S. patent or trademark. Ampoules Ephedriiw Hydrochloride-Abbott, 0.05 Gm., 1 cc. Capsules Ephedrine Hydrochloride-Abbott, y% grain. Capsules Ephedrine Hydrochloride-Abbott, 0.0324 Gm. (14 grain). Capsules Ephedrine Hydrochloride-Abbott, }i grain. Ephedrine Hydrochloride Solution- Abbott, 3%: It is preserved with chlorobutanol, 0.5 per cent. Tablets Ephedriiie Hydrochloride-Abbott , J4 grain. Tablets Ephedrine Hydrochloride-Abbott, Yz grain. Syrup Ephedrine Hydrochloride-Abbott : Contains ephedrine hydro- chloride- Abbott, 0.2195 Gm., in 10 cc. iVs grain per fluidrachm) and alcohol 12 per cent. Syrup Ephedrine Hydrochloride (Double Strength)-Abbott: Contain- ing ephedrine hydrochloride- Abbott, 0.4390 Gra., in 100 cc. ('^ grain per fluidrachm) and alcohol 12 per cent. Ephedrine Hydrochloride-Gane and Ingram. — A brand of ephedrine hydrochloride-U. S. P. Manufactured by Gane and Ingram, Inc., New York. No U. S. patent or trademark. Ephedrine Hydrochloride-Lilly. — A brand of ephedrine hydrochloride-U. S. P. Manufactured by Eli Lilly & Company, Indianapolis. No U. S. patent or trademark. Hypodermic Tablets Ephedrine Hydrochloride-Lilly, 0.016 Gm. (]4 grain). Hypodermic Tablets Ephedrine Hydrochlc^ride-Lilly, 0.0325 Gm. (y2 grain). Pulviiles Ephedrine Hydrochloride-Lilly, 0.025 Gm. (Yt grain). Pulvules Ephedrine Hydrochloride-Lilly, 0.05 Gm. (Y^ grain). Solution Ephedrine Hydrochloride-Lilly, 3%: It is preserved with chlorobutanol, 0.5 per cent. Syrup Ephedrine Hydrochloride: Contains ephedrine hydrochloride- Lilly, 0.22 Gm., in 100 cc. (1 grain per fluidounce) and alcohol, 12 per cent; it is flavored with vanillin, benzaldehyde and tolu, and tinted with amaranth. Ephedrine Hydrochloride-Merck. — A brand of ephedrine hydrochloride-U. S. P. Manufactured by Merck & Co., Inc., Rahway, N. J. No U. S. patent or trademark. Ephedrine Hydrochloride-P. D. & Co.— A brand of ephedrine hydrochloride-U. S. P. Manufactured by Parke, Davis & Company, Detroit. No U. S. patent or trademark. Capsules Ephedrine Hydrochloride-P. D. & Co., Y& grain. Capsules Ephedrine Hydrochloride-P. D. & Co., Ya grain. Ephedrine Hydrochloride-Squibb. — A brand of ephedrine hydrochloride-U. S. P. Manufactured by E. R. Squibb & Sons, New York. No U. S. patent or trademark. Tablets Ephedrine Hydrochloride-Squibb, Y& grain. Tablets Ephedrine Hydrochloride-Squibb, Ya grain. 220 NEW AND NONOFFICIAL REMEDIES EPHEDRINE SULFATE.— "When dried over sulfuric acid for twenty-four hours, contains not less than 75.5 per cent and not more than 11 .Z per cent anhydrous ephedrine (C10H15ON)." U. S.P. For standards see the U. S. Pharmacopeia under Ephedrinae Sulfas. Actions and Uses. — See preceding article, Ephedrine. Dosage. — See preceding article, Ephedrine. Ephedrine Nasal Jelly-Malthie : Ephedrine sulfate-U. S. P. 1 per cent, and sodium benzoate 0.5 per cent in a glycerite of tragacanth base. Prepared by The Maltbie Chemical Company, Newark, N. J. Ephedrine Sulfate-Abbott. — A brand of ephedrine sul- fate-U. S. P. Capsules Ephedrine Sulfate-Abbott, ^ grain. Capsules Ephedrine Sulfate-Abbott, J4 grain. Capsules Ephedrine Sulfate-Abbott, % grain. Solution Ephedrine Sulfate-Abbott, 3%. It is preserved with chloro- butanol 0.5%. Manufactured by the Abbott Laboratories, North Chicago, 111. No U. S. patent or trademark. Ephedrine Sul£ate-Gane and Ingram. — A brand of ephedrine sulfate-U. S. P. Manufactured by Gane's Chemical Works, Inc., New York (Gane and Ingram, Inc., New York, distributor). No U. S. patent or trademark. Ephedrine Sulfate-Lilly. — A brand of ephedrine sulfate- U. S. P. Manufactured by Eli Lilly & Company, Indianapolis. No U. S. patent or trademark. Ampoules Ephedrine Sulfate-Lilly, 1 cc, 0.05 Gm.: Each ampoule contains ephedrine sulfate-Lilly, 0.05 Gm. (^ grain) in 1 cc. of solution. Elixir Ephedrine Sulfate, 2 grains: Contains ephedrine sulfate-Lilly, 0.44 Gm. in 100 cc. (2 grains per fluidounce) in a menstruum composed of alcohol 12 per cent, glycerin, sucrose and water, flavored with gluside, oenanthic ether, oil of orange, oil of coriander, oil of caraway, oil of lemon, oil of cassia, oil of anise, safrol and vanillin. Hypodermic Tablets Ephedrine Sulfate-Lilly, 0.016 Gm. (% grain). Hypodermic Tablets Ephedrine Sulfate-Lilly, 0.0325 Gm. (Yz grain). Lilly's Ephedrine Jelly: Ephedrine sulfate-Lilly, 1 Gm. ; glycerin, 15 Gm.; tragacanth, 1 Gm. ; eucalyptol, 0.1 Gm.; oil of wintergreen, 0.005 Gm.; oil of dwarf pine needles, 0.005 Gm.; water to make 100 Gm. Pulvules Ephedrine Sulfate-Lilly, 0.025 Gm.: Each pulvule (filled capsule) contains ephedrine sulfate-Lilly, 0.025 Gm. (^ grain). Pulvules Ephedrine Sulfate-Lilly, 0.05 Gm.: Each pulvule (filled cap- sule) contains ephedrine sulfate-Lilly, 0.05 Gm. (54 grain). Solution Ephedrine Sulfate-Lilly, 3%: It is preserved with chloro- butanol, 0.5 per cent. Syrup Ephedrine Sulfate: Containing ephedrine sulfate-Lilly, 0.22 Gm., in 100 cc. (1 grain per fluidounce) and alcohol 12 per cent; it is flavored with vanillin, benzaldehyde and tolu, and tinted with amaranth. Syrup Ephedrine Sulfate: Containing ephedrine sulfate-Lilly, p. 44 Gm., in 100 cc. (2 grains per fluidounce) and alcohol, 12 per cent; it is flavored with vanillin, benzaldehyde and tolu, and tinted with amaranth. EPINEPHRINE 221 Ephedrine Sulfate-Merck. — A brand of ephedrine sulfate- U. S. P. Manufactured by Merck & Co., Inc., Rahway, N. J. No U. S. patent or trademark. Ephedrine Sul£ate-P. D. & Co. — A brand of ephedrine sulfate-U. S. P. Maufactured by Parke, Davis & Company, Detroit. No U. S. patent or trademark. Capsiiles Ephedrine Sulfate-P. D. & Co., 0.025 Cm. (}i grain). Capsules Ephedrine Sulfate-P. D. & Co., 0.05 Cm. (Y^ grain). Glaseptic Ampoules Ephedrine Sulfate-P. D. & Co., 0.05 Gm. (H grain), 1 cc. Solution Ephedrine Sulfate-P. D. & Co., 5%; It is preserved with chlorobutanol, 0.5 per cent. Epinephrine Epinephrine, the active principle of the suprarenal glands, is extensively used in surgery and to a less extent in medicine in the form of the 1 in 1,000 solution of epinephrine hydro- chloride (solution of epinephrine hydrochloride, U. S. P.). The alkaloid, in addition to being obtained from the suprarenal glands, is also prepared synthetically; and such preparations, if they are levorotatory, are equally as active as the natural product. Artificial epinephrines have also been prepared which are optically inactive, and such are only about half as active physiologically as is natural epinephrine. Dextrorotatory epine- phrine is almost inactive. The levorotatory product is the only one used in medicine. EPINEPHRINE. — Laevo-methylaminoethanolcatechol. — For standards see the U. S. Pharmacopeia under Epinephrina. Actions and Uses. — Epinephrine acts peripherally on a variety of structures by stimulating the myoneural junctions of the sympathetic nerve endings. Its most important actions consist of a constriction of the blood vessels, with consequent rise of blood pressure and slowing of the heart, and a direct stimulant effect on the heart muscle similar to that of digitalis. Relaxa- tion of the bronchial muscles and also glycosuria follow intra- muscular or hypodermic injection. Moderate doses, when given by mouth, have practically no action. However, in certain patients suffering with toxic thyroid, the administration of epinephrine by mouth may occasionally produce typical effects. The effect of a single intravenous dose is fleeting. Epinephrine is chiefly used locally for its vasoconstrictor action in hemorrhage, and in catarrhal and congestive conditions. It often relieves asthmatic paroxysms when used by hypodermic injection. If, however, asthmatic paroxysms are frequent it is generally advisable to use ephedrine with or in place of epinephrine. Intravenous injections are sometimes effective in shock and anesthesia accidents (care being taken not to give an overdose). It has also been employed in Addison's disease, 222 NEW AND NONOFFICIAL REMEDIES but it is apparently of little or no value in this condition. Epinephrine in the form of a 2 per cent solution of a salt of epinephrine has been used locally in the treatment of glaucoma with apparently favorable results in certain cases, while in other cases it appears to be ineffective. The vasoconstrictor action of epinephrine is used to prolong the anesthetic effect of local anesthetics by retarding the circula- tion in the injected area thus hindering the removal of the anesthetic agent by too rapid absorption into the blood stream. In the same manner it is believed to lessen the toxicity of the local anaesthetics by retarding their absorption into the general circulation. Dilute watery solutions rapidly lose their strength, the deterioration being accompanied by a reddish or brownish dis- coloration. Dosage. — Hypodermically or intramuscularly from 0.06 to 1 cc. (1 to 15 minims) of a 1 in 1,000 solution, diluted with sterile salt solution. Locally, it is used in solution varying in strength from 1 in 15,000 to 1 in 1,000. Epinephrine is also used in oily solution for sprays, in ointment for application to mucous membranes, such as the eye or the nose, where a slower but more lasting action is desired, and in suppositories. Adrenalin. — A brand of epinephrine-U. S. P. Made from the suprarenal gland. Manufactured by Parke, Davis & Company, Detroit. U. S. patents 730,175, 730,176, 730,196, 730,197, 730,198 (June 2 1903; expired); 753,177 (Feb. 23, 1904; expired). U. S. trademark 53,934. Adrenalin CJiloride Solution: A solution containing 1 part of adrenalin (as adrenalin chloride) in 1,000 parts of physiologic solution of sodium chloride preserved by the addition of 0.5 per cent of chloretone and not more than 0.1 per cent of sodium bisulfite. Adrenalin Inhalant: A glycerine solution containing 1 part of adrenalin (as adrenalin chloride) in 1,000, 3 per cent of chloretone, 15 per cent of alcohol, and aromatics. Adrenalin Ointment: Contains adrenalin chloride equivalent to one part of adrenalin in 1,000 parts of oleaginous ointment base. Adrenalin and Chloretone Ointment : Contains adrenalin chloride equiv- alent to one tenth per cent of adrenalin and 4.5 per cent of chloretone in an ointment base of hydrous wool fat and petrolatum. Adrenalin Suppositories: One part of adrenalin (as adrenalin chloride) to 1,000 parts of oil of theobroma (cacao butter) and not more than 0.2 per cent of sodium bisulfite. Each suppository weighs about 1 Gm. (15 grains). Adreiialin Tablets %oo grain: One thousandth Gm. (?ioo grain) adrenalin, as borate, yielding a 1 in 1,000 solution when dissolved in 15 minims (1 cc.) of water. Each tablet contains not more than ?ioo grain of sodium bisulfite. Adrenalin Tablets Vo.oo grain: Each contains adrenalin, 0.00033 Gm. (^/^OO grain) as borate, yielding a 1 in 1,000 solution when dissolved in 5 minims of water. Each tablet contains not more than l/^oo grain of sodium bisulfite. Adrenalin and Cocaine Tableis: Each hypodermic tablet contains cocaine hydrochloride 0.01 Gm. (J^ grain), adrenalin 0.00005 Gm. (M.300 grain) and not more than %oo grain of sodium bisulfite. EPINEPHRINE 223 Ampoules Adrenalin Chloride Solution 1:10,000, 1 cc: a solution of 1 part of adrenalin (as adrenalin chloride) in physiological solution of sodium chloride 10,000 parts, containing not more than 0.1 per cent of sodium bisulfite as preservative. Ampoules Adrenalin Chloride Solution 1:2,600, 1 cc: a solution of 1 part of adrenalin (as adrenalin chloride) in physiologic solution of sodium chloride 2,600 parts, containing not more than 0.1 per cent of sodium bisulfite as preservative. Ampoules Adrenalin Chloride Solution 1:1,000, 1 cc: a solution of 1 part of adrenalin (as adrenalin chloride) in physiological solution of sodium chloride 1,000 parts, containing not more than 0.1 per cent of sodium bisulfite as preservative. Suprarenalin. — A brand of epinephrine-U. S. P. Made from the adrenal gland. Manufactured by Armour & Co., Chicago. U. S. patent 829,220 (Aug. 21, 1906; expired). No U. S. trademark. Suprarenalin: Vials containing suprarenalin, 1 grain. Suprarenalin Ointment: One part of suprarenalin suspended in 1,000 parts of petrolatum base. Suprarenalin Solution: A solution containing adrenalin sulfite equiva- lent to 1 part of suprarenalin in 1,000 parts of physiological solution of sodium chloride without addition of other preservatives. SUPRARENIN. — Synthetic epinephrine obtained by the method of Stolz and Flaecher (Ztschr. f. physiol. Chem. vol. 58, p. 189). Actions, Uses and Dosage. — See Epinephrine. Synthetic epinephrine has the physiologic effects of natural epinephrine obtained from the adrenal gland. Manufactured by the Winthrop Chemical Co., Inc., New York. U. S. patent 986,156 (March 7, 1911; expired). Ampules Suprarenin Powder, 0.05 Cm.: Each ampule contains supra- renin bitartrate 0.091 Gm., equivalent to suprarenin 0.05 Gm. Ampules Suprarenin Solution: Each 1 cc. contains suprarenin bitar- trate equivalent to suprarenin 0.001 Gm. (Yes grain). Suprarenin Solution, 1 : 1,000 : Each 1 cc. contains suprarenin bitar- trate equivalent to suprarenin 0.001 Gm. (1^5 grain) and 0.5 per cent chlorobutanol. Tablets Suprarenin: Each tablet contains suprarenin bitartrate equiv- alent to 0.001 Gm. (%5 grain) of suprarenin. Synthetic epinephrine (the free base) is a white odorless powder, nearly insoluble in water, alcohol and ether. It melts at from 211 to 212 C. It rotates polarized light to the left, the rotation being 19.6 o [a] — — 51.4 D It has the chemical and physical properties of epinephrine obtained from adrenal glands. Suprarenin bitartrate is a white odorless powder soluble in water and yielding a solution which has an acid reaction. Suprarenin bitartrate melts at 149 C. and its aqueous solution rotates polarized light to the left. SOLUTION OF EPINEPHRINE HYDROCHLO- RIDE-U. S. P. — "A solution of epinephrine in distilled water and hydrochloric acid, containing, in each 100 cc, not less than 0.095 Gm. and not more than 0.105 Gm. of C9H13O3N." U. S. P. 224 NEW AND NONOFFICIAL REMEDIES For standards see U. S. Pharmacopeia under Liquor Epineph- rinae Hydrochloridi. Solution of Epinephrine Hydrochloride. — A brand of solution epinephrine hydrochloride-U. S. P. Manufactured by Abbott Laboratories, North Chicago, 111. Cheplin's Epinephrine Hydrochloride Solution. — A brand of solution epinephrine hydrochloride-U. S. P. Manufactured by Cheplin Biological Laboratories, Syracuse, N. Y. Cheplin's Epinephrine Hydrochloride Solution, Ampules, 1 cc. Solution Epinephrine Hydrochloride-Lederle. — A brand of Epinephrine Hydrochloride-U. S. P. Manufactured by Lederle Laboratories, Inc., Pearl River, N. Y. Solution Epinephrine Hydrochloride-Lederle (Steril- ized). — A brand of epinephrine hydrochloride-U. S. P. Manufactured by Lederle Laboratories, Inc., Pearl River, N. Y. Epinephrin Hydrochloride Solution 1 : 1000 (U. S. S. P. Co.). — A brand of epinephrine hydrochloride-U. S. P. Manufactured by United States Standard Products Co., Woodworth, Wisconsin. Epinephrin-Wilson. — A brand of epinephrine-U. S. P. Manufactured by Wilson Laboratories, Chicago. Epinephrin Powder-Wilson. Epinephrin Hydrochloride Solution-Wilson. — A brand of solution of epinephrine-hydrochloride-U. S. P. Manufactured by Wilson Laboratories, Chicago. Neo-Synephrin NEO-SYNEPHRIN HYDROCHLORIDE. — laevo-a- hydroxy-/3-methyl-amino-3-hydroxy ethylbenzene hydrochloride. — The hydrochloride of the laevo isomer of a synthetically prepared derivative of phenylethylamine having the formula C6H4OH.CHOHCH2NHCH3.HCL Neo-synephrin hydrochlo- ride differs from synephrin tartrate in that (1) neo-synephrin hydrochloride is a salt of hydrochloric acid — synephrin tartrate is a salt of tartaric acid ; (2) neo-synephrin hydrochloride is a laevo compound — synephrin tartrate is a racemic compound ; and (3) the hydroxyl of the nucleus in neo-synephrin hydro- chloride is in the meta position — in synephrin tartrate it is in the para position. Actions and Uses. — Neo-synephrin hydrochloride is a vaso- constrictor which is active when administered orally. It is more powerful in vasoconstrictive ability than synephrin tartrate, and possesses a relatively low toxicity. Applied to mucous membranes it causes contraction of the small blood vessels, thus reducing swelling and congestion of such membranes. Neo-synephrin hydrochloride may be useful in the symptomatic NEO-SYNEPHRIN 225 treatment of the nasal congestion accompanying disorders of the upper respiratory tract such as sinusitis, vasomotor rhinitis and hay fever. It may also be employed in combination with a local anesthetic, for surgical or dental use. Dosage. — For topical application to the nasal mucous mem- brane the 0.25 per cent solution is ordinarily used. The 1 per cent solution, diluted with an equal volume of physiologic solution of sodium chloride or Ringer's solution, may be used when a stronger preparation is desired. For surgical and dental anesthesia, it may be diluted in the proportion of three to four drops of the 1 per cent solution to 10 cc. of a 2 per cent procaine hydrochloride solution. Neo-synephrin hydro- chloride is relatively stable in alkaline solutions ; it may be sterilized by boiling. Manufactured by Frederic Stearns & Company, Detroit. U. S. patent 1,680,055 (Aug. 7, 1928; expires 1945). U. S. trademark 90,142. Neo-Synephrin Hydrochloride Emulsion (Aromatic) : Neo-synephrin hydrochloride 0.25 per cent, sodium benzoate 0.4 per cent, camphor 0.07 per cent, menthol 0.052 per cent, oil of red thyme 0.17 per cent in a mineral oil and water emulsion containing acacia. The product is pre- served with chlorobutanol 0.5 per cent. Solution Neo-Synephrin Hydrochloride, 0.25 Per Cent: Neo-synephrin hydrochloride 0.25 per cent, sodium benzoate 0.1 per cent, and sodium chloride 0.8 per cent, in distilled water. Solution Neo-Synephrin Hydrochloride, 1 Per Cent: Neo-synephrin hydrochloride 1 per cent, sodium benzoate 0.1 per cent, and sodium chloride 0.8 per cent, in distilled water. Neo-Synephrin Hydrochloride Jelly: Neo-synephrin hydrochloride, 0.5 per cent, incorporated in a jelly-like bland base composed of tragacanth, chondrus, glycerin and water. Sodium benzoate 0.5 per cent is present as preservative. The product is supplied in collapsible tube containers. Neo-synephrin hydrochloride occurs as white, odorless, nonhygro- scopic crystals possessing a bitter taste. It is readily soluble in water and alcohol. The aqueous solution is neutral to litmus paper. It melts between 139-141 C. The specific rotation [a] 25/D ranges between — 46.2 and — 47.2. Transfer 0.3 Gm. of neo-synephrin hydrochloride to a glass con- tainer, dissolve in 3 cc. of water, add 15 drops of ammonia water and rub the glass container with a glass rod: the base that separates when washed with cold water and dried melts at 170-171 C, without decom- position. Determine the nitrogen content of the base by the micro Dumas method: the nitrogen found is not less than 8.2 per cent nor more than 8.5 per cent. Dissolve 0.010 Gm. of neo-synephrin hydro- chloride in 1 cc. of water and add 1 cc. of copper sulfate solution (10 per cent) followed by 1 cc. of sodium hydroxide solution (20 per cent) : a reddish purple color forms that is not extracted by ether. Dissolve 0.01 Gm. of neo-synephrin hydrochloride in 1 cc. of water and add 1 drop of ferric chloride (10 per cent): a permanent amethyst purple color develops. Dissolve 0.02 Gm. of neo-synephrin hydro- chloride in 3 cc. of alcoholic potassium hydroxide solution, add 3 drops of chloroform and boil: there is no odor of carbylamine (absence of primary amines). Dissolve 0.05 Gm. of neo-synephrin hydrochloride in 30-40 cc. of distilled water, add 1 cc. of diluted hydrochloric acid in 1 cc. of barium chloride solution: no turbidity should result (absence of sulfate). Dissolve 0.2 Gm. of neo-synephrin hydrochloride in 10 cc. of distilled water: the solution yields a negative test for heavy metals when tested according to the U. S. P. X method (see U. S. P. X, page 439). To 1 cc. of a solution containing 0.02 Gm. of neo-synephrin hydrochloride add 2 drops of a freshly prepared solution of sodium nitroprusside, 1 per cent, then 1 cc. of sodium hydroxide solution 226 NEW AND NONOFFICIAL REMEDIES followed by 0.6 cc. (10 drops) of glacial acetic acid: the final solution should not be a deeper yellow than the same reagents, without the neo- synephrin hydrochloride {absence of corresponding ketone). Dissolve about 0.2 Gm. of neo-synephrin hydrochloride, accurately weighed, in 200 cc. of water, heat to boiling, add 4 cc. of diluted nitric acid, followed by silver nitrate solution in slight excess; allow the container and mixture to stand for six hours, transfer to a Gooch crucible, wash well with diluted nitric acid (10 cc. of diluted nitric acid diluted to 100 cc), dry at 100 C, cool in a desiccator and weigh: the chloride (Cl~) calculated from the silver chloride weighed is not less than 17.20 per cent nor more than 17.60 per cent. Heat about 0.2 Gm. of neo-synephrin hydrochloride, accurately weighed, for twenty-four hours, in an oven at 100 C. : the loss is not more than 0.1 per cent. Determine the nitrogen content by the micro Dumas method: the nitrogen found is not less than 6.7 per cent nor more than 7.0 per cent. Transfer about 0.5 Gm. of neo-synephrin hydrochloride, accurately weighed, to a platinum dish; ignite until constant weight is attained: the ash is less than 0.1 per cent. NEO-SYNEPHRIN HYDROCHLORIDE ONE PER CENT SOLUTION Transfer 10 cc. of the solution to a beaker, evaporate the solution to dryness on a boiling water bath, extract the residue with three 15 cc. portions of boiling absolute _ isopropyl alcohol, evaporate the isopropyl alcohol to dryness on a boiling water bath, dry the extract in an oven at 100 C. to constant weight: the residue is equal to not less than 0.95 per cent nor more than 1.05 per cent. The melting point ranges between 138 and 140 C. Dissolve the residue in 3 cc. of water, add 10 drops of ammonia water, rub the glass container with a glass rod, filter the precipitate, wash with cold water on a porous plate: the melting point is 169-171 C. NEO-SYNEPHRIN HYDROCHLORIDE J4 PER CENT SOLUTION Follow the standards as described for the 1 per cent solution except use a 25 cc. sample. ERGOT Ergot contains alkaloids which are specific for ergot, and a number of amines. These amines, however, are decomposition products of proteins and probably do not exist in fresh ergot. The chief constituents are : 1. Ergotoxine or hydroergotinine, CssHnOeNs, an amorphous alkaloid occurring in alcoholic extracts. It causes the charac- teristic reaction of ergot on the cock's comb, and is concerned in the uterine and vascular effects. It is rather unstable and by loss of water changes into its anhydride, crystalline ergo- tinine, C35H39O5N5, which possibly because of its low solubility in physiological solutions is quite weak in action. This pair of alkaloids, the amorphous and the crystalline ergotinine, exist already formed in ergot, and each member can easily be con- verted into the other by chemical means. Both are insoluble in water and petroleum benzin, sparingly soluble in ether, and readily soluble in almost all other organic solvents. Amor- phous ergotinine or ergotoxine is easily soluble in cold alcohol ; crystalline ergotinine is sparingly soluble. They dissolve in dilute sodium hydroxide; but the latter alkaloid is partially converted into ergotoxine. Their salts form colloidal solutions^ with water, but these are precipitated by electrolytes (salts or mineral acids). ERGOT 227 2. (a) Ergotamine, CssHssNbOs, a crystalline alkaloid. Ergo- tamine causes contraction of the uterus of the guinea-pig, rat and cat and of the human subject and increases the blood pressure through action on the motor endings of the sympathetic division of the autonomic nervous system. In sufficient dosage it causes darkening of the cock's comb (characteristic of the action of ergot), and with toxic doses convulsions and development of gangrene of the cock's comb or of the tail of the white rat. Ergotamine is insoluble in water, easily soluble in methyl and ethyl alcohol, acetone and chloroform and less so in ether. It forms water-soluble salts. Ergotamine and its salts crystaUize easily. It is unstable by its sensitiveness to heat, light, and air. By chemical means it is easily changed into (b) Ergotaminine. This is a crystalline isomer of ergot- amine. It is very slightly soluble in ethyl alcohol and other organic solvents, much less so than ergotamine and ergotoxine. It is strongly dextrorotatory, while ergotamine is levorotatory in chloroform. Ergotaminine is less active than ergotamine. 3. — P-hydroxyphenylethylamine, OH.C6H4.CH2.CH2NH2, or tyramine. This is closely related to epinephrine in structure and action. It is partially responsible for the pressor effect, but is not materially concerned in the uterine action. 4. — /3-iminazolylethylamine, 4-m-aminoethylglyoxaline, C3H3. N2CH2.CH2.NH2, or histamine. This lowers the blood pressure in carnivores and stimulates the excised uterus powerfully. A number of other aromatic amines occur, such as agmatine, guanidobutylamine and isoamylamine. Acetylcholine is fre- quently present, and lowers the blood pressure both by vaso- dilatation and by cardiac inhibition. These aromatic amines are not specific for ergot, being pro- duced by putrefaction in extracts of both animal and plant origin. They are derived from the amino-acids by the splitting off of carbon dioxide; tryamine from tryosine; histamine from histidine; agmatine from arginine; isoamylamine from leucine. It is not known whether they are present in fresh ergot or not ; but they have been shown not to be present in fresh rye. Ergotin is a term applied to a variety of pharmaceutical extracts, generally prepared in such a way that they contain mainly the amines, and relatively small amounts of the alkaloids. It will be seen that there are a number of the constituents of ergot which exert some effect upon the excised uterus, but only the alkaloids have a prolonged effect upon the human uterus when used clinically. The action of the amines is chiefly that of histamine, and such evidence as is available indicates that the action of this substance is transitory. Moreover histamine and tyramine require massive doses to produce their circulatory effects when given by mouth, and in the absence of positive evidence it is to be questioned whether any of the uterine effects which follow the oral administration 228 NEW AND NONOFFICIAL REMEDIES of active ergot preparations are to be ascribed to the relatively small amounts of amines present. The galenic preparations must vary in composition according to the solvent. The alcoholic fluid extract contains both the alkaloids and the amines ; the aqueous preparations, including the solid extracts and "ergotins," contain chiefly if not solely the non-specific amines. All ergot preparations, especially those containing water, deteriorate with age. It is necessary therefore to standardize them, and the date of assay should be indicated on the con- tainer. No satisfactory chemical method of standardization is available, and it is therefore necessary to use biological meth- ods. A number of different methods have been proposed, but if the current belief is confirmed that the activity of ergot as used clinically is due chiefly if not solely to the alkaloids present, then a method of assay should be used which is a measure of the alkaloidal content. In this country the cock's comb method (official in the U. S. P. X) or the Broom-Clark method (paralysis of the motor effect of epinephrine upon the isolated uterus of the rabbit) are commonly employed for this purpose. ERGOT.— Ergot of Rye.— Secale Cornutum P. I.— "The dried sclerotium of Claviceps purpurea (Fries) Tulasne (Fam. Hypocrcaceae), developed on rye plants. "Ergot, when assayed by the method directed in the U. S. Pharmacopeia, possesses a potency per gram equivalent to not less than 0.5 milligram of ergotoxine ethanesulfonate. It con- tains not more than 4 per cent of seeds, fruits and other foreign organic matter." U. S. P. For standards see the U. S. Pharmacopeia under Ergot. ERGOT ASEPTIC— A liquid extract of ergot, standard- ized by the cock's comb method of assay to have the same potency as fluidextract of ergot-U. S. P. Actions and Uses. — The same as those of ergot. Dosage. — 1 to 2 cc. Ergot aseptic is intended for intra- muscular injection. Ergot aseptic is marketed in ampules only. The date of manufacture appears on each package and the product is not guaranteed to possess its full potency for more than one year from time of manufacture. Manufactured by Parke, Davis and Co., Detroit. No U. S. patent or trademark. Ampoules Ergot Aseptic, 1 cc. Ergot is extracted with diluted alcohol acidulated with hydrochloric acid. The percolate is partially neutralized with alkali and concen- trated by distillation in a partial vacuum at a temperature not above 80 C. A large excess of alcohol is added to the concentrated percolate and the material which precipitates is removed. The liquid portion is freed from alcohol by distillation in a partial vacuum at a low tem- perature, and chlorobutanol in the proportion of 0.005 Gm. per cc. added ERGOT 229 to the aqueous slightly acid liquid. After three weeks the liquid is assayed, adjusted to proper volume and sealed in ampules. The finished ampules are tested for sterility and potency. Ergot aseptic is standardized to the same potency as fluidextract of ergot-U. S. P., as determined by the cock's comb method described in the U. S. P. X. GYNERGEN. — Ergotamine Tartrate.— (C33H3505N5)2.H2G HiOe. — The normal tartrate of one of the principal alkaloids of ergot, C83H35O5N5. Actions and Uses. — Gynergen stimulates the motor nerve end- ings of the sympathetic division of the autonomic nervous system, thus causing an increase in blood pressure, contraction of the uterus, etc. (the isolated uterus of the guinea-pig is affected in dilutions of from 1 in 150,000,000 to 1 in 200,000,000). In large doses it paralyzes the sympathetic nerve endings. It causes the darkening of the cock's comb characteristic of the action of ergot and in toxic doses causes gangrene and convul- sions. There is some evidence to show that Gynergen is of value in certain cases of migraine but the value of the drug in this condition at the present time is not yet completely estab- lished. The drug is not always a prophylactic and its continued administration will not always prevent attacks. Caution in its use is advisable on account of the danger of poisoning from long continued use or over dosage. Gynergen is proposed for use when the action of ergot to produce uterine contraction is desired ; it is contraindicated whenever tonic contraction of the uterus is undesirable. Gyner- gen is also stated to be indicated in hemorrhage following abortion, after curettage and in postpartum endometritis. It is also used by some physicians in conditions in which there is believed to be overactivity of the sympathetic nervous sys- tem, but its value here is not so well established. Dosage. — Intramuscularly, the average dose is 0.25 mg. ; orally, 1 mg. two to four times daily. Caution should be exer- cised in the repeated use of ergotamine ; cases of gangrene have been reported where the use of the alkaloid has been con- tinued over a period of some days. For migraine the dose recommended is 0.25 mg. by subcutaneous injection, to be fol- lowed in two or three hours by a full dose of 0.5 mg. if no untoward effects have been seen or if the original dose has not been effective. If preferred, tablets containing 1 mg. may be given by mouth, but this method of administration is not so effective as when the drug is given by the subcutaneous route. Manufactured by Sandoz Chemical Works, Basle, Switzerland (Sandoz Chemical Works, Inc., New York, distributor.) U. S. patent 1,394,233 (Oct. 18, 1921; expires 1938); 1,435,187 (Nov. 14, 1922; expires 1939). U. S. trademark 173,047. Ampules Gynergen Solution 1:2000, 0.5 cc: Each ampule contains 0.25 mg. of gynergen in an aqueous solution containing a small excess of tartaric acid. 230 NEW AND NONOFFICIAL REMEDIES Ampules Gynergen, 1 cc: Each cubic centimeter of solution contains 0.5 mg. of gynergen and a small excess of tartaric acid. Gynergen Solution 0.1 Per Cent: Each cubic centimeter of solution contains 1 mg. of gynergen, and a small excess of tartaric acid. Tablets Gynergen, 0.001 Gm. Ergotamine tartrate ordinarily crystallizes with solvents of crystal- lization. Ergotamine tartrate with ethyl alcohol of crystallization occurs as colorless rhombic crystals that are difficulty soluble in water; these crystals lose their solvent of crystallization (sometimes as much as 8 per cent) in a high vacuum beginning at ordinary temperature and raising the temperature to 105 C. Ergotamine tartrate is soluble in water (1 in 500) and in ethyl alcohol (1 in 500); on heating it blackens at 177 C, and at 184 C. it decomposes with the evolution of gas. Dissolves about 0.001 Gm. of ergotamine tartrate in a mixture of 5 cc. of glacial acetic acid and 5 cc. of ethyl acetate and to 1 cc. of this solution add slowly and with continual agitation and cooling 1 cc. of sulfuric acid: a blue color with a red tinge develops; add 0.1 cc. of diluted ferric chloride (1 in 1); the red tinge becomes less pronounced and the blue color more pronounced. Add 0.1 cc. of potassium mercuric iodide solution to 2 cc. of a solution of ergotamine tartrate (1 in 50,000) : a slight turbidity appears. Add 0.1 cc. of trinitrophenol solution to 2 cc. of a solution containing ergotamine tartrate (1 in 20,000): a turbidity appears. In a subdued light, transfer 0.5 Gm. of ergotamine tartrate to a separatory funnel containing 20 cc. of water and 1 cc. of ammonia water, shake the solution with three portions of chloroform (20 cc, 15 cc. and 15 cc), combine the chloroform extracts and evaporate spontaneously; transfer a weighed portion to a beaker, add 10 times the weight of acetone at 30 C; if the solid does not dissolve mark the height of the liquid in the beaker and then add twice the volume of acetone already present and warm; if the solid still does not dissolve, filter, reject the residue and evaporate the filtrate to the volume already marked; add 0.7 part of water and cool to C. for two hours, filter oflF the crystals and wash with 2 cc. of ether: the crystals are rhombic and are highly refractive. Dry the crystals for twenty-four hours in a high vacuum: the crystals lose their solvent of crystallization, and JDCCome a lusterless powder that has the following properties: on heat- ing, the powder blackens at 174 C. and decomposes with the evolution of gas from 181 to 182 C. It is very soluble in chloroform and glacial acetic acid, but is less soluble in alcohol, benzene and ether. 20 The specific rotation [a] — of a 0.6 per cent solution in chloroform D is between — 125 and — 155. ri?/ETHANOLAMINE-TECHNICAL.— A mixture con- taining approximately 75 per cent triethanolamine, (C2H40H)3N, 20 per cent diethanolamine, (C2H40H)2NH, and 5 per cent monethanolamine, C2H4OH NH2. Actions and Uses. — Triethanolamine-technical is an excellent emulsifying agent for use in the preparation of ointments and other dermatologic medicaments. When added to certain prepa- rations used on the scalp, for example, oil of cade, it facilitates their subsequent removal. Triethanolamine-technical combines with fatty acids to form soaps with good detergent properties, which are soluble not only in water but also in gasoline, kero- sene, and oils. It is claimed to have the power of increasing the penetration of oily substances and to possess a certain amount of bacteriostatic action. Ti?/ETHANOLAMINE-TECHNICAL 231 Dosage. — In the preparation of emulsions, the fatty acids are dissolved in oil, and the triethanolamine-technical in water, after which the two solutions are mixed. Emulsions are made in concentrations of from 20 to 40 per cent, which may be diluted subsequently. For emulsions containing olive oil the propor- tions are 2 per cent triethanolamine-crude to 15 per cent oleic acid. The same proportions are used for the majority of vege- table oil emulsions. For mineral oils less fatty acid is required. Trietbanolamine-technical is a colorless to pale yellow viscous, hygro- scopic liquid, with a slight ammoniacal odor. It is miscible with water and alcohol and is soluble in chloroform; immiscible with ether, benzene and purified petroleum benzin. The specific gravity is from 1.115 to 1.124 at 25 C. The refractive index is from 1.480 to 1.485 at 20 C. To 1 cc. of triethanolamine-technical add 0.1 cc. of copper sulfate solution: a deep blue color forms. Add 5 cc. sodium hydroxide solu- tion and concentrate to Yz volume by boiling: the color remains. To 1 cc. of triethanolamine-technical add 0.3 cc. of cobalt chloride solution: a carmine red solution forms. In a test tube place 1 cc. of triethanol- amine-technical, and by means of a slotted cork, suspend a piece of moistened red litmus paper in the air space, slot the side of the cork to let air escape, and place the tube in the steam-bath: the paper turns blue. To 2 cc. of a 2 per cent aqueous solution of triethanolamine- technical, add 2 drops of phenolphthalein indicator solution; an alkaline reaction is indicated. Weigh and transfer 50 cc. of triethanolamine-technical to a suitable Ladenburg distilling flask; attach the flask to a suitable condenser with receiver and slowly and carefully fractionate at a pressure of 10 mm. of mercury; not more than 8 per cent by weight of distillate is obtained below 89 C, of which 1 Gm. consumes not more than 15.4 cc, nor less than 14.3 cc. of normal hydrochloric acid when titrated as indicated for triethanolamine-technical; not more than 5 per cent by weight of residue is left after distillation below 209 C. Transfer 2 to 3 Gm. of triethanolamine-technical, accurately weighed, to an Erlenmeyer flask. Add 75 cc. of water and 0.1 cc. of methyl red indicator solution, and titrate with normal hydrochloric acid: not less than 6.7 cc, nor more than 7.8 cc. of normal hydrochloric acid is consumed per gram. The weight of the ash obtained from 1 Gm. of triethanolamine- technical, accurately weighed, is not more than 0.0001 Gm. Transfer about 1.5 Gm., accurately weighed, of triethanolamine- technical to a 100 cc. beaker, add 50 cc. of solution. A (dehydrated alcohol saturated with triethanolamine hydrochloride) and agitate the contents until the sample is dissolved. Add 10 cc. of solution B (100 cc of solution A treated with dry hydrogen chloride until the weight increases 20 Gm.). Stir the contents well and set the mixture aside 5 minutes. Filter the solution through a prepared Gooch crucible and complete transfer of the precipitate by washing with 5 to 10 one cc. portions of solution A, then cover the precipitate by adding slowly 40 cc. of solution A, at the same time applying gentle suction to the crucible. Follow by washing with five 10 cc. portions of solution C (a mixture of 6 volumes of anhydrous ethyl ether and 4 volumes of dehydrated alcohol saturated with triethanolamine hydrochloride). Finally remove all liquid by suction, allow air to be drawn through the crucible for several minutes and dry to constant weight at 105 C. The weight of triethanolamine calculated from the weight of triethanol- amine hydrochloride precipitate obtained is not less than 75 per cent of the weight of sample. Triethanolamine-Carbide and Carbon Chemicals Cor- poration. — A brand of triethanolamine-technical (N. N. R.). Manufactured by the Carbide and Carbon Chemicals Corporation, New York. 232 NEW AND NONOFFICIAL REMEDIES ETHYLHYDROCUPREINE Ethylhydrocupreine is a synthetic derivative of cupreine, C19H22O2N2. Cupreine is an alkaloid occurring together with quinine in the bark of Remijia pediincidata. Ethylhydrocupreine may also be synthetically made from quinine. It is closely related to quinine, differing from the latter in containing two more hydrogen atoms and an ethoxy group in place of a methoxy group. Ethylhydrocupreine has the antimalarial and anesthetic action of quinine. Toxic symptoms, however, such as tinnitus, deafness, amblyopia or amaurosis (retinitis) are more liable to occur than with quinine. While these are generally tran- sient, retinitis may result in permanent impairment of vision. This demands caution in the administration of the drug. Ethyl- hydrocupreine has a specific bactericidal effect on the pneumo- coccus in vitro and it exerts a protective and curative action in animals experimentally infected with virulent strains of pneumococci. The value of the drug in the internal treatment of lobar pneumonia in man has not been established. Ethyl- hydrocupreine hydrochloride has a definite value in the treat- ment of pneumococcic infections of the eye (ulcus corneae serpens). FIBRIN FERMENTS AND THROMBOPLASTIC SUBSTANCES The clotting of blood (that is, the transformation of the fibrinogen of circulating blood into the insoluble fibrin of blood clot) has been shown to be due to the action of the fibrin fer- ment (thrombin) on the fibrinogen of the blood. The fibrin ferment of thrombin exists in the blood in the form of its forerunner (prothrombin) which is acted on by the calcium salts and converted into thrombin. Besides calcium salts, how- ever, another factor is necessary. In spite of a sufficient supply of calcium salts, blood does not clot spontaneously within the vessels in health. This other factor may be furnished by the breaking down of blood cells or blood platelets or by the pieces of tissues that are cut or badly injured. It has been designated as "zymoplastic" substance by Schmidt, as "thrombokinase" by Morowitz, and as "thromboplastic substance" or "thromboplas- tin" by Howell. Howell believes that the reason why blood does not coagulate within the vessels is that the prothrombin exists there in combination with an inhibiting substance, anti- prothrombin (heparin) which prevents it from acting. He believes that when blood is shed or flows over injured tissue the thromboplastin derived from blood cells, blood platelets or tissue cells combines with, or neutralizes, the antiprothrombin (heparin), liberating the prothrombin from combination with the latter. The prothrombin thus liberated and activated by the calcium salts is converted into thrombin and converts the fibrinogen of the plasma into fibrin, causing coagulation to set in. Howell has shown that thromboplastin or "thromboplastic FIBRIN FERMENTS 233 substance," from every source in which he has investigated it, contains the phosphatid cephaHn (also written kephalin), and that the facilitating influence of thromboplastin on coagulation is due to the action of the cephalin. It is soluble in ether, but insoluble in alcohol and acetone. In solution or in solid form, cephalin gradually loses its power to hasten the clotting of blood, owing probably to an oxidation of the unsaturated fatty acids in the molecule. Actions and Uses. — Preparations containing thromboplastin are said to be useful when applied locally in the treatment of hemorrhage, especially hemorrhage from oozing surfaces, likewise in the treatment of scar tissues, in nosebleed, and in surgery of the bones, glands, nose and throat, but many sur- geons have abandoned their use even for such purposes. Intra- venous injection is probably dangerous, and there is no satisfactory evidence that subcutaneous injection is useful. Preparations should be standardized by testing on specimens of blood in vitro. They should be capable of reducing the coagu- lation time to about one third of its original length ; they should be proved to be sterile. The Council holds that there is no evidence to warrant the internal use of these substances, and further that such use, on account of the danger from anaphylaxis from preparations containing animal proteins, is likely to be harmful unless proper precautions are taken. There appears to be no evidence that this danger is connected with local application, but even before such use physicians should inquire into the patient's history to determine whether or not sensitivity to these proteins exists. BRAIN LIPOID.— Impure Cephalin.— Impure Kephalin.— An extract of the brain of the ox, or other mammal, prepared according to the method of Howell as applied in practice by Hirschfelder (Lancet 2:542, 1915) and described below. Actions and Uses. — See preceding article. Fibrin Ferments and Thromboplastic Substances, Dosage. — Brain lipoid may be spread on gauze sponges, on pledgets, or on the tissues themselves ; or an emulsion may be prepared by shaking up with physiological solution of sodium chloride and used in the same way or sponged over the tissues. For use in an office or dispensary, a 5 per cent ethereal solu- tion of brain lipoid suffices and can be kept ready for use for some time (several months) in a sterile dropper bottle from which an opalescent emulsion can be prepared extemporaneously by dropping from 10 to 30 drops into an ounce of physiological solution of sodium chloride and then shaking. This solution can also be dispensed by pharmacists, provided the opening in the stopper of the dropper bottle is kept slightly open to pre- vent the ether's blowing off when the bottle is shaken or heated. 234 NEW AND NONOFFICIAL REMEDIES Brain lipoid (impure cephalin) is prepared from ox brain which is run through a hashing machine, then covered with 3 volumes of alcohol and agitated two or three times. The excess of alcohol is then poured off and squeezed out gently through linen, care being taken to avoid great force in wringing out the alcohol, as this tends to break up the brain tissue_ into very finely divided particles which pass through the filter. The residue is then covered with 3 volumes of ether, shaken vigorously and filtered first through cotton and then through filter paper. The clear filtrate thus obtained is evaporated to dryness over a water bath, leaving a yellow residue of fatty appearance and con- sistency. (This residue consists largely of cephalin, but though the latter is not in the pure state, it is extremely active in accelerating the clotting of blood in vitro.) The method of preparation renders it sterile. It can be transferred on a sterile spatula or knife blade to sterile vessels. It retains its activities for several weeks. (The impurities, largely the lecithins and myelins, do not materially interfere with the activity of the cephalin, but, on the contrary, facili- tate its emulsification in physiological solution of sodium chloride and thus facilitate its intimate miscibility with blood.) FIBROGEN LOCAL-MERRELL.— Suspension of Tissue Fibrinogen and Cephalin for Local Use. — A sterile suspension of tissue fibrinogen and cephalin, containing 1.5 per cent tissue fibrinogen and 0.5 per cent cephalin in a solution of sodium chloride 0.9 per cent. Actions and Uses. — See preceding article, Fibrin Ferments and Thromboplastic Substances. Dosage. — Fibrogen Local-Merrell is applied locally, undiluted. Manufactured by the Wm. S. Merrell Company, Cincinnati, U. S. A. Patent Re 16,639. U. S. trademark 208,323. Fibrogen Local-Merrell, 7 cc. Vials. Fresh beef lungs are finely ground and extracted in the cold with 1.0 per cent sodium chloride solution. To the filtered extract is added an equal volume of saturated ammonium sulfate solution. The globulin fraction containing the tissue fibrinogen is precipitated and removed by filtration. Fibrogen is prepared from a 1.5 per cent dry weight sus- pension of_ this material in physiological saline. Complete sterilization is accomplished by the addition of bichloride of mercury which is sub- sequently removed by dialysis. After the mercury has been removed so that less than one part in 15,000 remains, sodium chloride is added to make a final concentration of 0.9 per cent. The amount of the residual mercury is determined by the following method: A measured volume of Fibrogen is digested in a specially constructed apparatus to avoid the loss of mercury. The amount of mercury present is measured by titration against standard KCN solution using di-phenyl- carbazone as an indicator. Cephalin, which functions as a stabilizer by preventing rapid loss of activity on exposure to heat is then added to the extent of 0.5 per cent. Fibrogen is preserved with sodium ethylmercuri thiosalicylate [Merthiolate] 1:10,000. Bacteriological tests are made to insure abso- lute sterility. The potency of Fibrogen Local-Merrell is determined by measuring its power to accelerate the clotting of recalcified, citrated or oxalated plasma or of blood. By the above tests the coagulation time is found to be reduced approximately 90 per cent. The following is a description of the method employed for measuring the thromboplastic activity of Fibrogen Local-Merrell: 10 cc. of blood are drawn from the heart of a rabbit into an oiled syringe. The blood is then transferred in 1.0 cc. quantities into each of six tubes previously placed in a water bath which is maintained at a temperature of 37.5 degrees C. To each of three tubes, which are FIBRIN FERMENTS 235 to serve as controls, is added 0.1 cc. of physiological saline and to each of the remaining tubes are added an equal amount of Fibrogen Local- Merrell. The contents of each tube are then thoroughly mixed. The blood contained in the tubes to which Fibrogen Local-Merrell has been added will have clotted solidly within 15 to 30 seconds, whereas the blood contained in the control tubes will require approximately IS to 25 minutes to clot. The time of coagulation of the blood, therefore, has been reduced approximately 90 per cent through the action of Fibrogen Local-Merrell. SOLUTION BRAIN EXTRACT.— Liquor Extract! Cerebri. — Solution Thromboplastin-Hess. — An extract of cattle brain in physiological solution of sodium chloride prepared by the method of Hess (/. A. M. A. 66:558 [Feb. 19] 1916, foot- note 2). Actions and Uses. — See preceding article, Fibrin Ferments and Thromboplastic Substances. Dosage. — The solution may be applied directly to the bleed- ing tissues or sprayed on them, or a sponge or tampon may be immersed in it and then pressed on the bleeding surface. Cattle brains are obtained fresh from the slaughter-house, stripped of their membranes, washed in running water and weighed. They are then passed through a meat chopping machine three times, and to the quantity prepared an equal quantity of physiological solution of sodium chloride is added. This suspension is allowed to remain in the refriger- ator for forty-eight hours, and is then pressed through cheese-cloth twice. This extract, which contains fine suspension of tissue in addition to tissue juice, is diluted with one half its volume of physiological solu- tion of sodium chloride. Cresol is then added in proper proportion so that the finished preparation contains 0.3 per cent. It maintains its hemostatic potency for some time (several months). (As cresol is not a perfect antiseptic, the sterility of this preparation cannot be guaranteed.) Thromboplastin Local-Lederle. — An extract of cattle brain in physiological solution of sodium chloride, prepared according to the method of Hess. Actions and Uses. — See preceding article, Fibrin Ferments and Thromboplastic Substances. Dosage. — See preceding article, Solution Brain Extract. Manufactured by the Lederle Laboratories, Inc., Pearl River, N. Y. No U. S. patent or trademark. Thromboplastin Local-Lederle, 20 cc. Vial. The potency of thromboplastin local-Lederle is tested as follows: Transfer 0.5 cc. of oxalated blood plasma (0.1 per cent oxalate) to each of a series of tubes, and add 0.2 cc. of thromboplastin local- Lederle to each tube. Also transfer 0.5 cc. of oxalated blood plasma to each of a control series of tubes and add 0.2 cc. of physiologic solu- tion of sodium chloride. To each tube (and control) add 0.2 cc. of calcium chloride solution the strength of which is determined by control tests as follows: that dilution of calcium chloride (usually 0.15, 0.25 or 0.5 per cent) is chosen with which the plasma forms solid clots in not less than 20 minutes: thromboplastin local-Lederle must cause clotting of the oxalated blood (such as to permit complete inversion of the tubes) within one minute; the controls must fail to show clotting at the expiration of 20 minutes. Thromboplastin Local-Squibb. — An extract of cattle brain in physiological solution of sodium chloride, prepared according to the method of Hess. 236 NEW AND NONOFFICIAL REMEDIES Actions and Uses. — See preceding article, Fibrin Ferments and Thromboplastic Substances. Dosage. — See preceding article, Solution Brain Extract. Manufactured by E. R. Squibb & Sons, New York. No U. S. patent or trademark. Thromboplastin Locnl-Sqiiibb. Dental Package, six 4 cc. vials. Thromboplastin Local-Sqiiihb, 20 cc. Vial. Blood plasma is obtained by bleeding 45 cc. of sheep's blood into a tube containing 5 cc. of 1 per cent sodium oxalate in physiological solution of sodium chloride, centrifuging the mixture to obtain the clear plasma and preserving this at a low temperature. A 0.5 per cent calcium chloride solution is prepared by dissolving 0.5 Gm. anhydrous calcium chloride in 100 cc. of physiological solution of sodium chloride. Place 5 drops of blood plasma in a flat bottomed vial, add 3 drops of calcium chloride solution and 2 drops of the thromboplastin local-Squibb to be tested and mix the contents by gentle rotation: no more than sixty seconds should elapse before the vial may be completely inverted without loss of its contents. FORMALDEHYDE PREPARATIONS AND COMPOUNDS WHICH LIBERATE FORMALDEHYDE The antiseptic actions of formaldehyde cannot be utilized directly on the body because of the irritant and coagulant effects. Attempts have been made to avoid these effects by combining the formaldehyde in such a way as to cause it to be liberated very gradually. The results have been rather disappointing, because it is difficult, if not impossible, to secure just that degree of stability in which the formaldehyde will be liberated in concentrations sufficient to maintain the antiseptic action, but not sufficient to become irritant. Methenamine (hexamethylenetetramine) is a notable exception ; but its effects are confined to acid fluids, and, therefore, essentially to the urine. Other compounds are effective mainly through the other constituents with which the formaldehyde is combined, rather than through the formaldehyde itself. The wide reactivity of formaldehyde gives the possibility of a great variety of compounds ; with proteins ; carbohydrates ; amides; phenols and aromatic derivatives. Methenamine does not contain formaldehyde as such, but liberates it under certain conditions. Formaldehyde Preparations PARAFORMALDEHYDE.— For description see the U. S. Pharmacopeia X under Paraformaldehydum. Actions and Uses. — It is converted into formaldehyde by heat, and is therefore used in fumigation. Formaldehyde is also liberated on contact with water, so that paraformaldehyde is antiseptic and escharotic. The rate of liberation, however, is variable, so that its internal employment is not advisable. Dosage. — Internally from 0.3 to 1 Gm. (5 to 15 grains) ; externally (for warts) in 10 per cent suspension in collodion. FORMALDEHYDE 2Z1 SOLUTION OF FORMALDEHYDE.— "An aqueous solution containing not less than Zl per cent of CH2O with variable amounts of methanol to prevent polymerization." V. S. P. For standards see the U. S. Pharmacopeia under Liquor Formaldehydi. Actions, Uses and Dosage. — See Useful Drugs. Formalin. — A brand of solution of formaldehyde-U. S. P. Schering & Glatz, Inc., New York, distributor. U. S. trademark 65,625. Methenamine and Methenamine Compounds Hexamethylenetetramine, official as methenamine, owes its action entirely to the liberation of formaldehyde, which occurs only in acid fluids. It is an active urinary antiseptic, provided the urine is secreted in an acid state. It has been shown that no antiseptic effects can occur in the body tissues and fluids which have a neutral or slightly alkaline reaction. Hexa- methylenetetramine is not a uric acid solvent, and in gout it has not given satisfactory results. Its use as a prophylactic against nephritis, especially in scarlatina, has been recommended by several authors. Yet hexamethylenetetramine itself may, at least sometimes, act as a renal irritant. The Council deems it a duty to call attention to this fact, and also to the statement of Jochmann that prophylactic drug treatment, as with hexamethylenetetramine, cannot prevent the nephritis of scarlatina. Hexamethylenetetramine compounds simply possess the actions of hexamethylenetetramine and of the salts of the acid with which it may be combined. METHENAMINE. — Hexamethylenamine. — Hexamethyl- enetetramine. — "Contains not less than 99 per cent of (CH2)8N4." U. S. P. For standards see the U. S. Pharmacopeia under Methenamina. Actions and Uses. — See preceding article, Methenamine and Methenamine Compounds. Methenamine-Calco.— A brand of methenamine-U. S. P. Manufactured by Calco Chemical Co., Inc., Bound Brook, N. J. Tablets Methcnaiiiinc-Calco, 5 grains. Formin. — A brand of methenamine-U. S. P. Merck & Co. Inc., Rahway, N. J., distributor. Formin Tablets, 5 grains (0.3 Gni.J. Formin Tablets, 7y^ grains (0.5 Gm.). Urotropin. — A brand of methenamine-U. S. P. Manufactured by Schering & Glatz, Inc., New York, U. S. trademark 269,754. Urotropin Tablets, 5 grains (0.3 Gm.). Urotropin Tablets, 7^ grains (0.5 Gm.). 238 NEW AND NONOFFICIAL REMEDIES GELATIN COMPOUND PHENOLIZED.— A mixture composed of gelatin, 625 parts ; zinc oxide, 250 parts ; glycerin, 1,900 parts; water, 1,900 parts, containing 1.5 per cent of phenol. Actions and Uses. — Gelatin compound phenolized is used in the preparation of bandages to cover chronic ulcers and unhealed secondary burns and in the preparation of pressure bandages for varicose veins when surgical treatment is not necessary. Dosage. — For use, the preparation is heated until it becomes liquid and is applied with a brush ; over this a spiral bandage is applied and another layer of the preparation brushed on; this is repeated until a total thickness of three layers of the bandage and four of the preparation has been applied. Manufactured by Sharpe & Dchme, Philadelphia and Baltimore. No U. S. patent or trademark. GOLD SALTS SODIUM GOLD THIOSULFATE.— Sodii et Aurii Thiosulfas. — Gold Sodium Thiosulfate. — Sodium Aurothiosul- fate, Na3Au(S203)2.2H20. The complex salt formed from 1 molecule of gold thiosulfate and 3 molecules of sodium thio- sulfate. It contains approximately 37.4 per cent of gold. Actions and Uses. — A review of the literature in regard to the use of gold and sodium thiosulfate in the treatment of lupus erythematosus reveals in general quite satisfactory clinical results, and it is considered a distinct advance in the therapy of this condition. Although there have been many recurrences in cases originally thought cured, nevertheless the beneficial and often curative action of the drug in a fair percentage of the cases seems to warrant giving it a definite place in the treatment of a disease for which at present there is no specific remedy. Gold and sodium thiosulfate must, however, be used with extreme caution. This is especially true in the presence of tuberculosis and in diseases of the liver and kidneys. Dosages at first advocated have been found to be too great, resulting frequently in severe reactions, sometimes resulting fatally. Even with much smaller doses, accidents of this kind have occurred. The reactions most commonly encountered are varying degrees of fever, diarrhea, vomiting, albuminuria, enteritis, stomatitis, prostration and shock. Skin reactions consist of varying degrees of erythema urticaria, severe papular and vesicular dermatitis, and scarlatinoform and exfoliative dermatitis. Cases of aplastic anemia, of hemorrhagic diathesis, and of agranulocytosis have also been noted following its use. Published necropsy reports reveal conditions usually found in metal poisoning. A certain number of cases of toxic hepatitis and of acute yellow atrophy have been noted after the use of this drug. Dosage. — At present the initial dose preferred is 0.005 Gm. (^/i2 grain) intravenously, given in from 2 to 5 cc. of sterile distilled water. Subsequent doses given at weekly intervals GOLD SALTS 239 are increased 0.005 Gm. (Yio grain) per dose, not exceeding a maximum of 0.05 Gm. for women and 0.075 Gm. (1^ grains) for men, provided no reactions have occurred. The drug may be continued cautiously in smaller dosage following complete recovery from mild reactions but should be discontinued perma- nently if severe reactions have occurred. A careful physical examination to rule out disease of the liver and kidneys, or other serious organic disorders, should be made before using this therapy. Cases of lupus erythematosus of the disseminated type are most likely to show an extreme idiosyncrasy for the drug, and if used at all in such cases it must be given in very small doses not exceeding 0.005 Gm. at the start and cautiously increased to a maximum of probably not over 0.025 Gm. Sodium gold thiosulfate occurs in white, glistening, needle-like or prismatic crystals. The aqueous solution is colorless. It is freely soluble in water; very slightly soluble in alcohol, ether and chloroform. An aqueous solution (1:200) is neutral or faintly alkaline to litmus. Sodium gold thiosulfate decomposes without melting when heated gently, leaving a brown residue on ignition. An aqueous solution (1:200) assumes a yellow color on standing and decomposes. Dissolve 0.1 Gm. of sodium gold thiosulfate in 20 cc. of water: separate portions of 2 cc. each yield a brick red precipitate with 0.4 cc. of silver nitrate solution; a purple red color followed by a gray brown precipitate on addition of 0.2 cc. of ammonia water and 0.5 cc. of solution of hydrogen peroxide, followed by heating to boiling point (distinction from arsenic, antimony and tin); no precipitate with 0.3 cc. of sodium iodide (IS per cent); a bluish purple (purplish gold) precipitate preceded by disappearance of the iodine color with 0.3 cc. of iodine test solution (presence of S2O3 — ) ; no precipitate in the cold, on addition of 0.5 cc. of concentrated hydrochloric acid, but on heating to boiling a precipitate then forms; a precipitate with 0.5 cc. nitric acid; no precipitate on addition of 0.2 cc. barium chloride solution and 0.2 cc. diluted hydrochloric acid (sulfate) ; no apparent change in cold or after heating with 0.4 cc. of sodium bisulfite solution (no auric compounds) . Dissolve about 0.5 Gm, of sodium gold thiosulfate, accurately weighed, in 5 cc. of water, carefully add 4-5 cc. nitric acid and 25 cc. water; agitate; when the reaction has subsided, filter the residue onto a tared Gooch crucible. Wash the residue with six 25 cc. portions of water and save the filtrate for determination of sulfur constituent. Wash the residue in the crucible with alcohol and ether after removal of the filtrate; dry the contents at 100 C. and ignite to constant weight. The weight of gold should not be less than 37 per cent nor more than 37.5 per cent. Transfer the filtrate from the gold precipitation to a 250 cc. volumetric flask and make up to volume by addition of water. Pipet 50 cc. of the solution to a 500 cc. beaker, add 5 cc. hydrochloric acid, evaporate to one-third volume, dilute to 250 cc, heat almost to boiling temperature, slowly add with stirring 10 cc. of hot barium chloride solution, digest, filter through a tared Gooch crucible, dry and ignite the residue to con- stant weight: the weight of barium sulfate corresponds to not less than 24.2 per cent nor more than 24.7 per cent of sulfur. Gold Sodium Thiosulfate-Abbott. — A brand of sodium gold thiosulfate-N. N. R. Manufactured by the Abbott Laboratories, North Chicago, 111. No U. S. patent or trademark. ^Ampules Gold Sodium Thiosulfate-Abbott, 0.01 Gm. Ampules Gold Sodium Thiosulfate-Abbott, 0.05 Gm. Ampules Gold Sodium Thiosulfate-Abbott, 0.1 Gm. Ampules Gold Sodium Thiosulfate-Abbott, 0.25 Gm. 240 NEW AND NONOFFICIAL REMEDIES Gold Sodium Thiosulfate-Merck. — A brand of sodium gold thiosulfate-N. N. R. Manufactured by Merck & Co., Inc., Rahway, N. J. No U. S. patent or trademark. Ampuls Gold Sodium Thiosulfate-Mcyck, 0.01 Gm. Ampuls Gold Sodium Thiosulfate-Mcrck, 0.025 Gm. Am,puls Gold Sodium Thiosulfate-Merck, 0.05 Gm. Ampuls Gold Sodium Thiosulfate-Merck, 0.10 Gm.. Ampuls Gold Sodium Thiosulfate-Merck, 0.20 Gm. Ampuls Gold Sodium Thiosulfate-Merck, 0.25 Gm. Ampuls Gold Sodium Thiosulfate-Merck, 0.30 Gm. Ampuls Gold Sodium Thiosulfate-Merck, 0.50 Gm. Ampuls Gold Sodium Thiosulfate-Merck, 1.0 Gm. Gold Sodium Thiosulfate-Searle. — A brand of sodium gold thiosulfate-N. N. R. Manufactured by G. D. Searle & Co., Chicago, 111. No U. S. patent or trademark. Ampuls Gold Sodium Thiosulfate-Searle, 5 cc: Gold sodium thio- sulfate-Searle, 0.05 Gm., sodium thiosulfate, 0.75 Gm. Each ampule contains more than 5 cc. of solution. TRIPHAL. — A product consisting essentially of sodium aurothiobenzimidazole carboxylate, CeHsN : NHCSAu.COONa, with a small amount of a product of indefinite composition. The sodium salt of a compound formed by the interaction of gold halides with thiobenzimidazole carboxylic acid. Triphal con- tains from 44 to 47 per cent of gold. Actions and Uses. — Proposed for use as a gold salt in the treatment of lupus erythematosus. Foci of infection, if present, should be removed before beginning treatment with triphal. It is contraindicated in pregnancy, kidney disease, acute progres- sive pulmonary tuberculosis and intestinal tuberculosis. Patients receiving triphal should be kept away from strong sunlight and should receive no actinotherapy. Generalized pruritis may result from idiosyncrasy or metallic retention. The development of erythema or albuminuria indicates intolerance to the drug ; on its appearance triphal should be discontinued and intravenous injections of sodium thiosulfate instituted. Dosage. — For adults, initial dose, intravenously, 0.005 Gm. {Vi2 grain), the dose being gradually increased to 0.075 Gm. (1^ grains) ; for children, average initial dose, 0.0005 Gm. (K.30 grain), gradually increased, if possible, to 0.025 Gm. (^ grain) once a week. Manufactured by the Winthrop Chemical Co., Inc., New York. U. S. patent 1,558,584 (Oct. 27, 1925; expires 1942). U. S. trademark 188,475. Ampules Triphal, 0.025 Gm. Ampules Triphal, 0.1 Gm. Triphal occurs as a light yellow, odorless powder, readily soluble in cold water, insoluble in alcohol and ether. An aqueous solution of Triphal is slightly alkaline in reaction, is stable for only a short time, and is readily decomposed by heat. On addition of mineral acids to solution, a precipitate is produced, soluble on addition of excess alkali solution. HYDROCHLORIC ACID SUBSTITUTES 241 Dissolve 0.1 Gm. triphal in 1 cc. water; a clear solution results. Transfer 1 cc. of triphal solution (1:200) to a clean test tube con- taining a freshly prepared solution of sodium stannite (prepared by adding sufficient stannous chloride slowly to 2 cc. of dekanormal sodium hydroxide solution, until the precipitate barely dissolves). Gently heat the solution to the boiling point; a metallic mirror is formed. To 3 cc. of solution (1:200) add 1 cc. dekanormal sodium hydroxide solution and 0.15 cc. freshly prepared phenylhydrazine hydrochloride solution (1:10); a blue color is produced, which appears reddish in reflected light. To 4 cc. of the solution (1:200) add 0.15 cc. alkaline mercuric potassium iodide solution; a pronounced yellowish color is produced. Dissolve 0.1 Gm. of triphal in 3 cc. water, add 0.2 cc. of diluted acetic acid, and filter; the filtrate shows no brown coloration after adding 0.1 cc. of sodium sulfide solution. To 2 cc. of solution (1:50) add 0.2 cc. diluted nitric acid and filter; to one half of the filtrate add 0.2 cc. barium nitrate solution; no precipitate occurs (sulfate); to the other portion of acidified solution add silver nitrate solution; not more than a faint turbidity appears (halides). To 4 cc. of triphal solution (1:100) add 0.2 cc. sodium nitrite solution and 0.2 cc. diluted hydro- chloric acid, followed by the addition of sufficient betanaphthol solution (0.01 Gm. in 5 cc. of sodium hydroxide solution) that the precipitate formed redissolves; no red color appears. Ignite 0.1 Gm. of triphal in a porcelain crucible, extract the residue with normal hydrochloric acid, and filter; the filtrate gives a characteristic sodium flame test and yields a white precipitate with a solution of barium chloride. Dry about 0.1 Gm. of triphal, accurately weighed, for eight hours at 100 C. The loss in weight should not be more than 8.0 per cent nor less than 6.0 per cent of sample weight. Transfer approximately 0.2 Gm. triphal, accurately weighed, into a tared porcelain crucible, and ignite well at red heat. Extract the residue with six 5 cc. portions of normal hydrochloric acid solution; filter each portion through an ashless filter paper. Transfer the remaining residue to the filter and wash with five 3 cc. portions of water. Transfer filter and residue to crucible, dry, and ignite to constant weight. The weight of the residue corresponds to not more than 50.0 per cent and not less than 47.8 per cent of gold, calculated to the dried basis. HYDROCHLORIC ACID SUBSTITUTES Several solid substances have been introduced as medicinal substitutes for hydrochloric acid. It is claimed that these have the action of the free acid in the stomach, but are without the marked acid taste. They also permit the administration of the acid in dry form. These bodies contain hydrochloric acid in combination with organic substances from which the free acid is readily spht off. The physiologic activity of these compounds varies in marked degree with the separability of the hydrochloric acid. The dissociation of the hydrochloric acid, on which the prac- tical value depends, is in some cases nearly complete in aqueous solution, but is much less marked in the case of the large protein-like complexes. Actions and Uses. — It seems to be possible to secure the antiseptic and digestive action of free hydrochloric acid from some of these products, while from others the liberation of the halogen acid is probably insufficient to accomplish these ends in any marked degree. 242 NEW AND NONOFFICIAL REMEDIES BETAINE HYDROCHLORIDE.— Betainae Hydro- chloridum. — C5HUNO2.HCI. — The hydrochloride of betaine, an alkaloid found in the beet, Beta vulgaris j and in many other plants. Actions and Uses. — In the dry state betaine hydrochloride does not split off hydrochloric acid at ordinary temperature. In aqueous solution, betaine hydrochloride is decomposed into betaine and hydrochloric acid (hydrogen chloride). Since betaine has no physiologic action, betaine hydrochloride is a convenient method of administering hydrochloric acid. Betaine hydrochloride is used for the same purpose as hydrochloric acid. Dosage. — Five-tenths Gm, (8 grains) which corresponds to about 1.1 cc. (18 minims) of diluted hydrochloric acid-U. S. P., to be taken dissolved in water. Betaine hydrochloride consists of colorless crystals, freely soluble in water. It contains 23.8 per cent of absolute hydrochloric acid. Betaine Hydrochloride-Roche. — A brand of betaine hydro- chloride-N. N. R. Manufactured by F. Hoffmann-LaRoche & Co., Basle, Switzerland (HoflFmann-LaRoche, Inc., Nutley, N. J., distributor). No U. S. patent or trademark. HYPOCHLORITES AND HYPOCHLORITE SUBSTANCES The germicidal action of free chlorine and the hypo- chlorites is well known. In medicine this action has been utilized by the employment of chlorine water, chlorinated lime, solution of chlorinated soda (Labarraque's solution), and solution of chlorinated potassa (Javelle water). Hypochlorite preparations are fairly permanent in the presence of alkali, and alkaline hypochlorite preparations have the added advantage that the alkali has a destructive and solvent action on most bacteria and other organic matter. In the treatment of infected wounds with hypochlorite solutions at present in vogue, an excessive degree of alkalinity is held to be objectionable on the grounds that it causes destruction of normal tissue and irritation of the skin. Organic preparations containing a chloramide group, which are practically neutral and relatively stable have been proposed as substitutes for hypochlorites on the theory that the action of hypochlorites is dependent on the combination of their active chlorine (C1+) with nitrogen of proteins. Hypochlorite Preparations HYCLORITE.— A solution of chlorinated soda, each 100 Gm. of which is stated to contain sodium hypochlorite 4.05 Gm., sodium chloride 2.50 Gm., calcium hydroxide 0.14 Gm., inert HYPOCHLORITES 243 salts 0.65 Gm. It contains not less than 3.85 per cent of available chlorine. Actions and Uses. — Hyclorite differs from solution of chlorinated soda-U. S. P., chiefly because of the greater content of available chlorine and the lesser degree of alkalinity of the former. It has the actions and uses of solution of chlorinated soda-U. S. P., and when properly diluted it also may be used in the same conditions as those for surgical solution of chlori- nated soda-U. S. P. One volume of hyclorite diluted with 7 volumes of water has the same available chlorine content as surgical solution of chlorinated soda, and is isotonic. Dosage. — Hyclorite is used full strength or diluted with 1 or 2 parts of water for direct application to mucous membrane, muscular tissue, bone infections, etc. For irrigation of wounds, throat and body cavities, dilutions of from 1 in 200 to 1 in 2,000 are used. For use in the irrigation method of treating infected wounds, dilute 1 part of hyclorite with 7 parts of water. The available chlorine content of hyclorite decreases at the rate of about 12 per cent per year. In order that due allowance for this decrease may be made when diluting for use, each bottle of hyclorite bears the date of bottling. Manufactured by General Laboratories, Inc., Philadelphia, Pa. (Beth- lehem Laboratories, Inc., Pittsburgh, Pa., distributor). No U. S. patent. U. S. trademark 120,110. Hyclorite is prepared by decomposing chlorinated lime suspended in water with sodium carbonate. Hyclorite has the properties of solution of chlorinated soda-U. S. P., but contains no carbonate. When exposed to air, a pellicle forms on its surface owing to the formation of calcium carbonate. _ To a definite weight of hyclorite, about 5 grams, is added 50 cc. of distilled water. To the resulting solution, 10 cc. of a 3 per cent hydro- gen peroxide solution, previously rendered neutral, is slowly added. After the reaction is completed, which is indicated by the ceasing of the evolution of oxygen, 4 drops of methyl orange indicator solution and an excess (measured) of tenth-normal hydrochloric acid are added, and then the residual acidity determined by titration with tenth-normal sodium hydroxide: the alkalinity found corresponds to not more than 0.14 Gm. of calcium hydroxide per 100 Gm. of hyclorite. Mix in a flask about 5 cc. of hyclorite, accurately weighed, with 50 cc, of distilled water; add 1 Gm. of potassium iodide and 5 cc. of acetic acid and titrate with tenth-normal sodium thiosulfate, starch test solution being used as indicator: it shows not less than 3.85 per cent of available chlorine. Each cc. of tenth-normal sodium thiosulfate used corresponds to 0.003546 Gm. oi available chlorine. Due allowance should be made for th« decrease in available chlorine content of about 12 per cent per year, date of bottling being stamped on each bottle. Chloramine Preparations AZOCHLORAMID. — A product containing approximately 96 per cent of N,N-Dichloroazodicarbonamidine. — (H2N(C1N): C-N=N-C:(NC1).NH2)— An N-chloro derivative of azodicar- bonamidine. Actions and Uses. — Similar to those of chloramine-T, dichlor- amine-T, and diluted solution of sodium hypochlorite, over which 244 NEW AND NONOFFICIAL REMEDIES it is claimed to have an advantage in that it possesses lower reactivity with extraneous organic matter and higher bacteri- cidal activity in the presence of organic material. Solutions of azochloramid are proposed for dressing, packing or irrigating infected wounds and cavities. Internal use of azochloramid solutions is not recommended. The available evidence indicates that the substance possesses a relatively low toxicity. Dosage. — Azochloramid is usually employed in concentrations of 1 : 1,600 and 1 : 3,300 in approximately isotonic buffered saline solutions. A solution containing one part of azochloramid in 500 parts of glyceryl triacetate (triacetin) and possessing greater stability than the aqueous solutions may also be used. Manufactured by Wallace & Tiernan Products, Inc., Belleville, N. J. (Davis Emergency Equipment Co., Inc., New York, Industrial Distributor.) U. S. patents 1,958,370 (May 8, 1934; expires 1951) and 1,958,371 (May 8, 1934; expires 1951). U. S. trademark. Azochloramid Buffered Saline Mixture (for preparing 1 liter of a 1 :3,300 aqueous solution) : Vials containing azochloramid 0.3 Gm., sodium phosphate 0.6 Gm., potassium phosphate (monobasic) 0.9 Gm., and sodium chloride 8.5 Gm. Azochloramid Buffered Saline Mixture (for preparing 1 gallon of a 1:3,300 aqueous solution): Vials containing azochloramid 1.14 Gm., sodium phosphate 2.27 Gm., potassium phosphate (monobasic) 0.34 Gm., and sodium chloride 32.18 Gm. Azochloramid Buffered Saline^ Mixture _ (for preparing 1 liter of a 1:1,600 aqueous solution): Vials containing azochloramid 0.6 Gm., sodium phosphate 0.6 Gm., potassium phosphate (monobasic) 0.09 Gm., and sodium chloride 8.5 Gm. Azochloramid Buffered Saline^ Mixture (for preparing 1 gallon of a 1: 1,600 aqueous solution): Vials containing azochloramid 2.27 Gm., sodium phosphate 2.27 Gm., potassium phosphate (monobasic) 0.34 Gm., and sodium chloride 32.18 Gm. AzocJdoramid in Triacetin 1:500: A solution containing azochloramid 1 Gm. in 500 Gm. of triacetin (triacetin, a mixture containing approxi- mately 95 per cent glyceryl triacetate. CH0OOCCH3.CHOOCCH3.CH2 OOCCH3). Azochloramid Solution in Triacetin 1:125: A solution containing Azochloramid 1 Gm. in 125 Gm. of triacetin (triacetin, a mixture con- taining approximately 95 per cent glyceryl triacetate (CH2OOCCHS. CHOOCCH3.CH0OOCCH3) for use in the preparation of azochloramid in olive oil 1:2,000 (one volume of azochloramid in triacetin 1:125 diluted with 15 volumes of olive oil). Azochloramid occurs in bright yellow needles or plates. It possesses an odor suggestive of chlorine and has a burning taste. When pure it is odorless and practically tasteless. It is very slightly soluble in water, slightly soluble in glycerin and ether; soluble in alcohol; soluble (incompletely) in glacial acetic acid, acetone and ethyl acetate; very slightly soluble in chloroform, and nearly insoluble in carbon tetra- chloride and liquid petrolatum. Azochloramid decomposes (explosively) without melting at 155.0-155.5 (U. S. P. X. Melting Point Method). Solutions of azochloramid decompose on exposure to light. Agitate 0.01 Gm. of azochloramid with 35 cc. of water: a practically complete solution (yellow-orange) occurs with only a very slight tur- bidity at most. Treat 5 cc. portions of this solution as follows: Add 0.25 cc. of silver ammonium nitrate solution: a brick-red precipitate forms, soluble in an excess of ammonia water; add 2 cc. of potassium iodide solution and agitate with 0.5 cc. of chloroform: the chloroform layer is colorless or at most very faintly colored; add 0.1 cc. of diluted hydrochloric acid to the mixture and further agitate: the chloroform layer acquires a deep violet color; add 2 cc. of diluted nitric acid solution and 1 cc. of silver nitrate solution: a slight white turbidity but no precipitate forms; add sulfurous acid solution until the yellow HYPOCHLORITES 245 color disappears: add 2 cc. of diluted nitric acid solution and 1 cc. of silver nitrate solution and agitate; a curdy, white precipitate remains soluble on addition of excess ammonia water: add from 30 to 40 cc. of water and treat according to the U. S. P. X turbidimetric test for chlorides: the turbidity is less than that produced in a control test made with 0.1 cc. of fiftieth nonnal hydrochloric acid. Dissolve about 0.1 to 0.15 Gm. of azochloramid, accurately weighed, in 20 cc. of glacial acetic acid in a glass stoppered 250 cc. Erlenmeyer flask. Add 10 cc. of potassium iodide solution and 50 cc. of distilled \yater, allow the mixture to stand for ten minutes and titrate the liberated iodine with tenth-normal sodium thiosulfate. The number of cubic centimeters of tenth-normal sodium thiosulfate consumed per gram (due to active chlorine and the azo group, — N = N — ) is not less than 317 cc. nor more than 328 cc. Dissolve from 0.12 to 0.15 Gm. of azochloramid, accurately weighed in 15 cc. of glacial acetic acid contained in a 400 cc. beaker; add 90 cc. of water with stirring and follow with sufficient sulfurous acid solu- tion to produce a clear colorless solution. Add 20 cc. of silver nitrate solution and 20 cc. of diluted nitric acid solution. Heat the solution until it boils and set aside for several hours. Filter through a prepared Gooch crucible and wash the precipitate well with jiortions of hot water slightly acidified with nitric acid, wash with one portion of cold water, dry at 105 C. for one and one-half hours, cool and weigh: the chloride (Cl~) calculated from the silver chloride weighed is not less than 38.25 per cent nor more than 38.75 per cent. Heat from 0.2 to 0.3 Gm. of azochloramid, accurately weighed, for five hours at 100 C.: the loss in weight is not less than 0.4 per cent nor more than 0.7 per cent. Heat about 0.25 Gm. of azochloramid, accu- rately weighed, in a platinum dish, until constant weight is attained: the ash is less than 0.1 per cent. The triacetin used in Azochloramid in Triacetin 1:500 complies with the following tests and standards: Triacetin is a colorless, somewhat oily liquid with a slight fatty odor and a bitter taste. It is miscible with alcohol, ether, chloroform and benzene; soluble in water; insoluble in carbon disulfide, and ligroin. The specific gravity is from 1.154 to 1.158 at 25 C. The refractive index is 1.4295-1.4310 at 25 C. Transfer 25 cc, of triacetin to a distillation flask. Determine the distillation range according to method I of the U. S. P. X. Ninety-five per cent distils over at from 258 to 259 (corrected) at 760 mm. The saponification value as determined by the method of the U. S. P. X, page 457, on 0.5 to 0.6 Gm. of triacetin, accurately weighed, is not less than 762 nor more than 772. Dilute 0.4 cc. of bromcresol green indicator solution (0.04 per cent of monosodium salt according to Clark and Lubbs) to 30 cc. Transfer 15 cc. of this solution to 5 cc. of triacetin in a separatory funnel and agitate vigorously for two minutes: the color of the clear aqueous extract (centrifuge if necessary) shows no appreciable change from that of the original solution at the end of fifteen minutes. Reflux a mixture of 150 cc. of triacetin and 100 cc. of dry toluene for one hour in a glass apparatus for the determination of water as described in the Proceedings of the American Society for Testing Materials, A. S. T. M. Designation: D 95-30. Not more than 0.75 cc. of water collects in the graduated trap. CHLORAMINE-T.— Chloramina U. S. P. X.— Chloramine. — "Sodium paratoluenesulfonchloramide contains the equivalent of not less than 11.5 per cent and not more than 13 per cent of active chlorine." U. S. P. For standards see the U. S. Pharmacopeia under Chlor- amina-T. Actions and Uses. — The actions of chloramine-T are essen- tially similar to those of diluted solution of sodium hypochlorite- 246 NEW AND NONOFFICIAL REMEDIES U. S. P. It has the advantages of greater stability, convenience of preparation, and the production of less irritation. On the other hand, it lacks the solvent action of alkaline hypochlorites. It is practically nontoxic, but should not be used by mouth, since it is decomposed by the gastric juice. Dosage. — Chloramine-T is used in 0.1 to 4 per cent aqueous solution. For wounds, the normal strength is from 1 to 2 per cent, applied by the same technic as the surgical solution of chlorinated soda. It has also been employed for irrigation of the urethra, bladder and uterus, and as a mouth wash. Chloramine-T (Monsanto). — A brand of Chloramine-T- U. S. P. Manufactured by Monsanto Chemical Works, St. Louis. Chloramine-T (Squibb). — A brand of Chloramine-T-U. S. P. Manufactured by E. R. Squibb & Sons, New York. Chlorazene. — A brand of chloramine-T — U. S. P. Manufactured by the Abbott Laboratories, North Chicago, 111. No U. S. patent; U. S. trademark 119,014. Aromatic Chlorazene Powder: Chlorazene, 5 per cent; sodium bicar- bonate, 5 per cent; eucalyptol, 2 per cent; saccharin, 1 per cent; sodium chloride, 87 per cent. Chlorazene Surgical Cream: Chlorazene 1 Gm. in 100 Cm. of a base composed approximately of sodium stearate 15 per cent and water 85 per cent. Chlorazene Tablets, 4.6 grains. DICHLORAMINE-T. — Dichloramina U. S. P. X.— Dichloramine. — "Paratoluenesulfondichloramide, containing the equivalent of not less than 28 per cent and not more than 30 per cent of active CI." U. S. P. For standards see the U. S. Pharmacopeia under Dichlor- amina-T. Actions and Uses. — Dichloramine-T is an effective germicide through its content of active chlorine (C1+). It is only spar- ingly soluble in water, but soluble in chlorinated eucalyptol or chlorinated paraffin (chlorcosane). The solution produces a gradual, sustained antiseptic action. It is more irritant than chloramine, but also more solvent. It should not be administered internally. Dichloramine-T is claimed to be useful in the prevention and treatment of diseases of the nose and throat; it has been used with success when applied to wounds. Dosage. — Dichloramine-T dissolved in chlorinated paraffin (which see) is used in concentrations of from 0.5 to 10 per cent. In nasopharyngeal work from a 1 to a 2 per cent solu- tion is employed; for application to wounds a 5 per cent solution. The solution of dichloramine-T in chlorinated paraffin is not very stable and should not be kept for more than two or three days. At times the solutions may become irritating to the skin because of the formation of hydrochloric acid. Both dichloramine-T powder and solution should be protected from sunlight to prevent decomposition. HYPOCHLORITES 247 DiCHLORAMiNE-T (Abbott). — A brand of dichloramine-T- U. S. P. Manufactured by Abbott Laboratories, North Chicago, 111. DiCHLORAMiNE-T (MoNSANTo). — A brand of dichloramine-T U. S. P. Manufactured by Monsanto Chemical Works, St. Louis. HALAZONE. — /^-sulfonedichloramidobenzoic acid. — CflH,(S02NCl2)COOH-l :4. Actions and Uses. — Halazone is said to be a powerful disinfectant. It is said to act like chlorine, but to have the advantage of being stable in solid form. In the presence of alkali carbonate, borate and phosphate, Dakin and Dunham report that, in from thirty to sixty minutes, halazone in the proportion of from 1 in 200,000 to 1 in 500,000 sterilized polluted water contaminated with such organisms as BacUhis coli. Bacillus typhosus, Bacillus paratyphosus A and B, Cholera vibrio and Bacillus dysenteriae. Dosage. — For the sterilization of water, 0.004 to 0.008 Gm. of halazone, in the form of tablets containing sodium carbonate (or sodium borate) and sodium chloride, is added to 1 liter. Parasulfonedichloramidobenzoic acid was first prepared by H. D. Dakin and E. K. Dunham {Brit. M. J. 1: 682 [May 20] 1917) under the name "Halazone." Halazone is a white powder having a strong odor of chlorine. It is slightly soluble in water and chloroform; insoluble in petroleum ether; soluble in glacial acetic acid, benzene, and with the formation of the salt in alkali hydroxide solutions. It crystallizes in stout prisms from glacial acetic acid. The melting point of pure halazone is 213 C. Halazone liberates iodine from a sodium iodide solution, and bromine from a sodium bromide solution. If 15 cc. of a saturated aqueous solution of anilin is treated with 0.05 Gm. of halazone, the solution acquires a brownish-red color, which becomes deep blue on supersaturation with ammonia water. If 0.1 Gm. of halazone is treated with a few drops of concentrated sulfuric acid, chlorine is evolved, but no blackening occurs {readily carbonizable matter.) About 0.150 Gm. of halazone (or in the case of halazone tablets, 30 tablets), accurately weighed, is dissolved in from 50 to 100 cc. of water and 10 cc. of a 10 per cent sodium hydroxide solution. Fifteen cc. of a 10 per cent potassium iodide solution is added, and the mix- ture is then acidified with acetic acid and titrated with tenth-normal sodium thiosulfate volumetric solution. (If the reagents used liberate iodine, the number of cubic centimeters of tenth-normal sodium thio- sulfate volumetric solution required for tbeir decolorization should be deducted from the total volume used.) The chlorine content of halazone should not be higher than 26.26 per cent or lower than 24 per cent. Each cubic centimeter of tenth-normal sodium thiosulfate volumetric solution is equivalent to 0.00177 Gm. of active chlorine. The theoretical chlorine content of pure halazone is 26.26 per cent. Halazone-Abbott. — A brand of halazone-N. N. R. Manufactured by the Abbott Laboratories, North Chicago. No U. S. patent or trademark. Halazone Tablets-Abbatt : Halazone-Abbott, 0.004 Gm. sodium borate, 0.011 Gm,, and sodium chloride enough to make approximately 0.13 Gm. Halazone-Monsanto. — A brand of halazone-N. N. R. Manufactured by Monsanto Chemical Works, St. Louis. No U. S. pat- ent or trademark. 248 NEW AND NONOFFICIAL REMEDIES IODINE COMPOUNDS Iodine compounds are used partly for their local irritant and antiseptic effects, which are due probably to the action of free iodine contained in the preparations or liberated from them, and partly for their systemic actions, and also for roentgen-ray diagnosis. These may be discussed separately under the head- ings of "Iodine Preparations Containing Free Iodine," "Iodine Dusting Powders," and "Iodine Compounds for Systemic Use," the last named group being subdivided into : "Iodine-Proteins," "Iodine Aliphatic Compounds," "Iodized Fats," "Iodized Quino- line Derivatives," and "Water- Soluble Iodine Compounds for Intravenous Pyelography." Iodine Preparations Containing Free Iodine IODINE. — "Contains not less than 99.5 per cent of I." U. S. P. For standards see the U. S. Pharmacopeia under lodum. lOCAMFEN.— A liquid obtained by the interaction of iodine 10 parts, phenol 20 parts and camphor 70 parts, con- taining about 7.25 per cent free iodine. Actions and Uses. — locamfen has the antiseptic and germi- cidal properties of iodine and the analgesic and stimulating properties of camphor and phenol. locamfen is used especially in the treatment and dressing of surgical and traumatic wounds, and in dentistry ; also in ring- worm of the feet, nails, and other parts of the body. Dosage. — locamfen is applied in small quantities directly to wounds, the skin, cavities, etc., or on tampons or drainage material. Manufactured by Schering & Glatz, Inc., New York. No U. S. patent. U. S. trademark 112,934. locamfen is a dark, reddish-brown, viscid liquid, having a cam- phoraceous odor. locamfen is insoluble in water, but soluble in all proportions in alcohol, ether, benzin and liquid petrolatum. locamfen, like free iodine, interacts with fats and waxes, its free iodine entering into combination. The free iodine content of iocamfen may be determined thus: About 2 Gm. iocamfen is weighed into a glass-stoppered flask, dissolved in about 25 cc. of chloroform, about 10 cc. of potassium iodide solution (1 in 10) added, and the free iodine determined by titration, under agitation, with tenth-normal sodium thiosulfate solution, using starch as an indicator. CAMIOFEN OINTMENT.— An ointment obtained by mixing iocamfen (a liquid obtained by the interaction of iodine 10 parts, phenol 20 parts and camphor 70 parts, containing about 7.25 per cent free iodine) with an equal weight of a mixture composed of lard, wax and oil of theobroma, but containing nearly all of its iodine in combined form. Actions and Uses. — The ointment has the properties of fatty iodine compounds, phenol and camphor. IODINE 249 It is used in skin diseases, inflammatory swellings, itching, etc. Dosage. — It is applied directly or on gauze, undiluted or mixed with fatty substances. The parts to which camiofen oint- ment is applied should be dry, and the application of mercuric chloride before or after the use of the ointment must be guarded against. Prepared by Schering and Glatz, Inc., New York. No U. S. patent. U. S. trademark 119,578. Iodine Dusting Powders Dusting powders containing iodine in various combinations are widely used in the treatment of w^ounds, granulating surfaces, abscess cavities, etc., whether due to syphilis or tuberculosis or to other infections. The clinical results are ascribed to a slight antiseptic action of the iodine, to stimulation of phagocytosis, and to diminished secretion from the wound which renders it a less favorable culture medium for germs. Iodoform has been the standard drug of tliis class. Other insoluble organic iodine compounds have been introduced to replace iodoform, but with limited success. While they avoid the disagreeable odor and the occasional toxic systemic effects, they also lack much of the efficiency. THYMOL IODIDE.— "A mixture of iodine derivatives of thymol, principally dithymol-diiodide [(CeH2.CH3.QH7. 01)2], containing, when dried to constant weight over sulfuric acid, not less than 43 per cent of I." U. S. P. For standards see the U. S. Pharmacopeia under Thymolis lodidum. Thymol Lodide-Merck. — A brand of thymol iodide-U. S. P. Manufactured by Merck & Co., Rahway, N, J. Aristol. — A brand of Thymol Iodide-U. S. P. Manufactured by Winthrop Chemical Company, Inc., New York. U. S. trademark 17,393. VIOFORM-CIBA.— lodochlorhydroxyquinoline. — C0H4N. OH. I. CI. — A substitution compound of anachlor-ortho-hydroxy- quinoline resulting from the introduction of one atom of iodine. Actions and Uses. — Vioform-Ciba is used as an almost odor- less substitute for iodoform, and internally against amebiasis. The diagnosis of amebiasis depends on the observation of motile forms or cysts of Endameba histolytica in stool speci- mens (repeated examinations are often necessary) or their recovery by means of the proctoscope from the intestinal mucosa ; positive diagnosis can often be made by the latter procedure when stool examinations are negative, and this is considered to be the more satisfactory as well as the more rapid method of diagnosis in many cases. 250 NEW AND NONOFFICIAL REMEDIES In view of the frequency of persistent infection in the absence of marked symptoms, adequate therapy includes re-examinations and repetitions of courses of treatment. Dosage. — Vioform-Ciba is used as a dusting powder for application to wounds, ulcers, burns, exudative skin eruptions, etc. Against amebiasis 0.75 Gm. to 1.0 Gm. daily (in capsules in divided doses of 0.25 Gm. [4 grains]) by mouth for 10 days, with repetition of the course after a rest period of a week to ten days. A few cases of gastro-intestinal irritation with this dosage have been reported; on account of the high iodine con- tent the possibility of iodism should be kept in mind. Until more evidence becomes available, vioform should be used with caution in cases with liver damage. Manufactured by the Society of Chemical Industry in Basle, Switzer- land (Ciba Co., Inc., New York). U. S. patent 641,491 (Jan. 16, 1900; expired). U. S. trademark 92,72,2. Vioform-Ciba is a grayish-yellow powder, having a very faint aromatic odor, almost insoluble in water, sparingly soluble in alcohol, soluble in hot glacial acetic acid. Boil vioform-Ciba with dilute hydrochloric acid: it dissolves slowly, evolving an odor of iodine. Treat a specimen of vioform-Ciba with concentrated sulfuric acid: copious vapors of iodine are evolved. Repeatedly crystallize vioform-Ciba from hot glacial acetic acid: crystals are obtained which melt at 178 to 180 C. Mix about 0.5 Gm. of vioform-Ciba, accurately weighed, in a nickel crucible with a mixture of powdered sodium hydroxide 4 parts and potassium nitrate 1 part, and heat until fusion has been completed. Cool and dissolve the fused mass in 150 cc. of water, warming to hasten solution; filter into a 400 cc. beaker and wash well. Add 25 cc. of tenth-normal silver nitrate (the amount of silver is k in the formula below) ; then add slowly, with stirring, nitric acid until acid in reaction to litmus paper. Filter the solution through a weighed Gooch crucible, wash and titrate the excess silver nitrate in the filtrate with tenth- normal potassium _ sulfocyanate (the amount of silver jn the filtrate is a). The precipitate in the Gooch crucible (consisting mainly of silver iodide with some silver chloride) is further washed with 3 por- tions of alcohol, then with ether, dried at 100 C. and weighed (w). The amount of iodine can be calculated according to the formula. 0.7527 w -\- a — k ~ 293 where w equals combined weight of silver iodide and silver chloride; X equals weight of silver^ iodide and {w-x) equals weight of silver chloride by this method vioform-Ciba contains not less than 37.5 per cent nor more than 41.5 per cent of iodine, and not less than 11.5 per cent nor more than 12.2 per cent of chlorine. Iodine Compounds for Systemic Use These are typified by sodium iodide and potassium iodide. The mechanism of their action is not clearly understood. The most definite results are seen in the rapid absorption of certain inflammatory exudates and especially of the gummatous lesions of tertiary syphilis. Lesions of this type in bone, skin, brain, or other organs diminish or disappear under adequate doses of the drug. In actinomycosis and sporotrichosis the action of iodine as iodide is almost specific. The iodide ion is not germicidal. IODINE 251 The beneficial effect of iodides in arteriosclerosis and aneu- rysm is probably limited to the absorption of syphilitic deposits in the vessel wall. The iodides do not directly lower blood pressure. They may tend to affect the production of thyroxin and may thus exert an indirect effect on metabolism. Iodides in very small amounts are effective in the prophylaxis of simple endemic goiter. Iodine compounds with proteins and fats have been intro- duced with claims that they are less irritating to the digestive tract and that they are less inclined to set up the disagreeable symptoms of iodism, for instance, coryza and skin eruptions. Experience confirms in a measure the former claim, but the latter is misleading. Iodism is probably a necessary manifes- tation of the full physiologic activity of the drug. If, therefore, a preparation consistently fails to elicit these characteristic symptoms, it may be presumed that the amount of the drug absorbed is insufficient to produce the full effects, such as are required in the treatment of syphilis, although it may suffice in conditions for which a milder action is desired. Clinical observations establish the fact that the organic iodides, in the dosage ordinarily employed, are weaker than full doses of the inorganic forms. IODINE-PROTEIN COMPOUNDS lodalbin and iodo-casein appear to suffer little change in the acid contents of the stomach, but on passing into the intestines they are dissolved and decomposed by contact with the alka- line secretion and absorbed chiefly, if not entirely, as iodide ions; their actions and uses are therefore identical with those of the inorganic iodides. The slower absorption may result in a more continuous action, but this seems to be of small importance. lODALBIN.— A compound of iodine and blood albumin, containing approximately 21.5 per cent of iodine. Actions and Uses. — See preceding article, Iodine-Protein Compounds. Dosage. — From 0.3 to 0.6 Gm. (5 to 10 grains) repeated according to indications. Manufactured by Parke, Davis & Company, Detroit. No U. S. patent or trademark. lodalbin Capsules, 5 grains. lodalbin and Mercurol Tablets: lodalbin, 5 grains (0.32 Gm.), and mercurol, 1 grain (0.06 Gm.). lodalbin is prepared by treating blood albumin with a solution of iodine whereby an insoluble precipitate is produced. This precipitate is separated, purified by the removal of free iodine, dried, powdered and assayed. lodalbin is a reddish-colored powder, practically tasteless and pos- sessing a peculiar, rather pleasant odor suggestive of cane syrup or molasses. It is almost insoluble in water, acids, alcohol and other ordinary solvents, but is readily soluble in strong alkaline solutions; xnore slowly soluble in dilute alkaline solutions. When heated, it 252 NEW AND NONOFFICIAL REMEDIES evolves iodine vapors copiously and is subsequently consumed to an ash, leaving a small amount of residue. The presence and amount of iodine can be determined by the usual processes for detecting and estimating this element in organic substances. lODO-CASEIN. — Casein-Iodine. — A compound of iodine with milk casein, containing about 18 per cent of iodine in organic combination. Actions and Uses. — See preceding article, Iodine-Protein Compounds. Dosage. — From 0.3 to 1.3 Gm. (5 to 20 grains), as indicated. For goiter prophylaxis, the equivalent of 0.01 Gm. iodine, or about 0.05 Gm. Manufactured by Sharp & Dohme, Philadelphia and Baltimore. No U. S. patent or trademark. lodO'Casein Tablets, 5 grains (0.3 Gm.). Tablets lodo-Casein with Chocolate: Each tablet contains iodo-casein equivalent to 0.01 Gm. iodine. Iodo-casein is prepared by treating a solution of casein in sodium carbonate with a solution of iodine and precipitating with acetic acid Iodo-casein is a yellowish-brown powder, almost odorless and taste- less, insoluble in water, or acid solutions. It is partially dissolved and decomposed by alkalis. IODIZED ALIPHATIC COMPOUNDS lOTHION. — lopropane. — Diiodohydroxypropane. — 1.3- diiodopropane-2-ol. — CH2l.CH(0H).CHJ. lothion contains from 77 to 80 per cent of iodine. Actions and Uses. — lothion is absorbed from the intact skin and is used when it is desired to obtain the systemic effect of iodides by external application. It is claimed to be practically unirritating to the skin in the concentrations ordinarily used, and to produce no discoloration. Dosage. — lothion is used in the form of iothion oil, in solu- tion in alcohol or glycerin, or in the form of ointments con- taining from 5 to 20 per cent of iothion. It is applied without friction, and the parts are not bandaged. Manufactured by Winthrop Chemical Company, New York. lothion Oil: lothion, 10 parts; chloroform, 10 parts; olive oil, 80 parts, lothion is a yellowish, oily liquid having a faint but not unpleasant odor. It is insoluble in water; soluble in alcohol, ether, chloroform, carbon disulfide, glycerin and oils. It is volatile at body tempera- ture. It is decomposed by alkalis and weakly alkaline solutions. The specific gravity is from 2.4 to 2.5 at 20 C. Heat about 1 Gm. of iothion, accurately weighed, on the water bath under a reflux condenser, with 25 cc. of half normal alcoholic potas- sium hydroxide for from five to six hours. Dilute with water and evaporate the alcohol. Add a slight excess of diluted sulfuric acid and a few cubic centimeters of sodium nitrate solution, and extract with carbon disulfide until all of the iodine has been removed. Titrate the carbon disulfide solution with tenth-normal sodium thiosulfate in the usual way: the tenth-normal sodium thiosulfate consumed indi- cates not less than 77 per cent nor more than 80 per cent of iodine. IODINE 253 SIOMINE. — Hexamethylenetetramine tetraiodide. — Meth- enamine tetraiodide (CH2)6N4l4. Siomine contains 78.5 per cent of iodine. Actions and Uses. — Siomine is decomposed in the intestine with formation of hexamethylenetetramine and iodide, the rate of absorption and excretion being essentially the same as that of inorganic iodides. It, therefore, produces the effects of ordi- nary iodides, from which it differs only in that it can be admin- istered in solid form. No therapeutic claims are made for the hexamethylene- tetramine component of siomine, this serves only to render the substance insoluble. While ordinarily the hexamethylenetetramine content of siomine may be ignored, the drug should be discontinued if any signs of hexamethylenetetramine intolerance arises, such as vesical irritation or hematuria. Dosage. — The same as that of potassium iodide. Siomine is best administered in capsule form during or immediately follow- ing meals. Manufactured by Pitman-Moore Company, Indianapolis. U. S. patent 1,226,394 (May 15, 1917; expired). U. S. trademark 107,998. Siomine Capsules, Yz Grain: Siomine Vi grain (0.03 Gm.) and lactose 4^ grains (0.29 Gm.). Siomine Capsules, 1 Grain: Siomine 1 grain (0.06 Gm.) and lactose 4 grains (0.26 Gm.). Siomine Capsules, 2 Grains: Siomine 2 grains (0.13 Gm.) and lactose 3 grains (0.19 Gm.). Siomine Capsules, 5 Grains: Siomine 2 grains (0.3 Gm.) and lactose 2 grains (0.13 Gm.). Hexamethylenamine tetraiodide was described by Herton in 1888, and a process essentially the same as that used for the preparation of siomine is described by Sugiura and Falk {Biocliem. Bull. 5: 18, 1916). Under the name siomine, it was first proposed for therapeutic use. Siomine is a red powder, having a slight, but characteristic, odor and taste. When heated to 138 C, it decomposes with violence. Siomine is slightly soluble in acetone, alcohol, chloroform, carbon disulfide and ether (with partial decomposition). It is almost insol- uble in water, but dissolves with decomposition in aqueous solutions of alkali iodides and of sodium thiosulfate and in diluted hydrochloric acid. Heat 5 Gm. of siomine with 15 cc. of diluted sulfuric acid: first, vapors of iodine (recognized by their color and effect on starch paper) are evolved; later, formaldehyde is given off (recognized by its odor and the blackening of paper moistened with silver ammonium nitrate solution). Heat the siomine-sulfuric acid mixture until it is color- less; supersaturate with potassium hydroxide solution: ammonia is evolved (recognized by its odor and effect on red litmus paper). To 0.5 Gm. of siomine add a drop of strong sulfuric acid: decomposition occurs with evolution of brown fumes. Warm 0.5 Gm. of siomine with 0.5 cc. of water vmtil a clear solu- tion results: the addition of a few drops of barium chloride solution does not produce a precipitate ^sulfates). Incinerate a weighed quantity of siomine: not more than 0.03 per cent of ash remains. 254 NEW AND NONOFFICIAL REMEDIES IODIZED FATS AND FATTY ACIDS Iodized fats and iodized fatty acids produce in general the same systemic effects as ordinary (inorganic) iodides ; but their iodine is more slowly absorbed and excreted, and therefore more persistently retained; especially in tissues rich in lipoids, such as the nervous structures. The iodized fats and fatty acids generally pass the stomach unchanged, and are saponified and absorbed in the small intes- tine, like ordinary fats. They are then deposited for the most part in lipoid tissues, where they are gradually oxidized, yield- ing inorganic iodide, which is given off to the blood and excreted. The iodine content of the blood is thus maintained more uniform than when inorganic iodides are administered. It is conceivable that iodized fats and fatty acids have thera- peutic advantages over ordinary iodides when a gradual, long- sustained iodide action is desired; but the clinical evidence is not decisive. The doses used in these conditions as a rule are not irritating to the stomach and are not likely to produce iodism. Hypodermic injections remain unabsorbed for long periods, and do not produce systemic actions, except in very hypersensitive individuals, for instance, in tuberculosis. Iodized oils are injected as contrast mediums in roentgen diagnosis, especially of tumors of the spinal cord ; in the locali- zation of bronchial and pulmonary lesions; and in gynecology. Various vegetable oils may be used ; animal oils cause local irritation. According to the method of iodation, the oil may contain iodine alone, or iodine and chlorine ("chloriodized oils"). These do not differ essentially. Iodized oils are quite viscid. For injections into cavities they may be thinned, for instance, by diluting with ethyl oleate; they may be rendered water-miscible by emulsification. Caution. — "It should be emphasized that the injection of iodized oils is essentially a surgical procedure, introducing a foreign and possibly irritant body, and involving more or less risk, which should be weighed against the presumptive advan- tages, in comparison with the relative advantages and disad- vantages of other measures. The following cautions should be especially borne in mind : "1. Oils that have aged and darkened beyond their original color should never be used. "2. Subarachnoid injections should be avoided, at least until all other means of diagnosis have been exhausted. "3. Intratracheal and intrapleural injections should be avoided in tuberculosis of the respiratory organs and also when restric- tion of respiratory area would be contraindicated. "4. The injection pressure should be carefully controlled, so as not to lacerate the tissues. "5. Intra-uterine injections should be made only under fluoro- scopic observations. IODINE 255 "6. Iodized oil should not be used for renal pyelography, except in the form of emulsion; and the injection should be stopped if pain is felt. "7. Intravascular injections with iodized oil appear too dan- gerous; the use of emulsions for this purpose requires further study." (Dangers of the Injection of Iodized Oils, Report of the Council on Pharmacy and Chemistry. The Journal, A. M. A. 99:1946, Dec. 3, 1932. The full report may be con- sulted for further discussion of the history, scope and limita- tions of iodized oils.) 8. When the so-called per-nasal method of injecting the oil into the larynx is employed, it should be remembered that in the injection of the local anesthetic required for this procedure, the risk of intoxication from the anesthetic is greatly enhanced as the absorptive surface is increased. CHLORIODIZED RAPESEED OIL.— A halogenated addition product of rapeseed oil containing from 24 to 26 per cent iodine and from 7 to 8 per cent chlorine in organic combination. Actions and Uses. — In the form of an emulsion, chloriodized rapeseed oil is used as a roentgenographic opaque medium in urography. Dosage. — The amount of emulsion to be used is determined by the size of the cavity to be visualized. Intravenous and intraspinal injections are contraindicated. Manufactured by the Dermatological Research Laboratories branch of the Abbott Laboratories, North Chicago, 111. U. S. patent 1,870,023 (Aug. 2, 1932; expires 1949). Ampules Campiodol Emulsion, 20 cc: Chloriodized rapeseed oil 5 cc, acacia solution (35 per cent) 5 cc, and distilled water 10 cc. Chloriodized rapeseed oil is a yellow, semiviscous oil, having an alliaceous odor and an oleaginous taste, soluble in benzene, carbon disulfide, chloroform and ether, insoluble in alcohol and water. On exposure to air and sunlight it decomposes, turning a brown color. Specific gravity at 20 C, from 1.2 to 1.3. Boil about 0.5 cc. of chloriodized rapeseed oil and 20 cc. of half- normal potassium hydroxide alcoholic solution, in a porcelain dish for about ten ininutes, evaporate the liquid on a water bath and ignite the residue. Dissolve the residue in 10 cc. of water, filter the solution, add 5 cc. of nitric acid and 2 cc. of silver nitrate solution to the filtrate; collect the precipitate consisting of a mixture of silver chloride and iodide on a filter, wash with diluted nitric acid and water, percolate the precipitate obtained with 10 cc. of diluted ammonium hydroxide several times: a white, curdy precipitate results on the addition of an excess of diluted nitric acid. Mix 10 cc. of chloriodized rapeseed oil with 50 cc. of purified petroleum benzin: a transparent liquid results. Dissolve about 1 cc. of chloriodized rapeseed oil in 10 cc. of chloro- form, add a few drops of phenolphthalein solution and 0.3 cc. of tenth- normal sodium hydroxide solution: the liquid becomes red (limit of acidity). Shake 1 cc. chloriodized rapeseed oil with 50 cc. of water, allow the oil to separate, filter the supernatant layer through a wetted filter: the filtrate yields no more than a slight opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution (soluble inorganic halides). Ignite about 1 Gm. of chloriodized rapeseed oil accurately weighed; the residue does not exceed 0.01 per cent. Transfer about 0.3 Gm. of chloriodized rapeseed oil, accurately weighed, to a bomb tube; deter- 256 NEW AND NONOFFICIAL REMEDIES mine chlorine and iodine contents by the modified Carius method. Collect the insoluble residue of silver halide on a filter paper, wash thoroughly with diluted nitric acid and water, puncture the filter, wash the insoluble material into a 250 cc. glass stoppered Erlenmeyer flask, using about 100 cc. of previously filtered stronger ammonium hydroxide, stopper the flask, shake the flask and contents and allow to stand for one hour. Collect the insoluble residue of silver iodide on a tared Gooch crucible, wash with diluted ammonium hydroxide and water, and dry to constant weight at 100 C. : the amount of iodine found is not less than 24 per cent nor more than 26 per cent. To the ammoniacal filtrate from the iodine determination add 25 cc. of potassium iodide solution and remove the ammonia by heating on a water bath, collect the insoluble residue of silver iodide on a tared Gooch crucible, wash with water and dry to constant weight at 100 C: the amount of silver iodide found calculated as chlorine is not less than 7 per cent nor more than 8 per cent. lODOSTARINE-ROCHE. — Diiodotariric acid.— dsHas I2O2. — An iodine addition product of tariric acid, C18H32O2, derived from the fruit of a species of Picramnia. lodostarine- Roche contains 47.5 per cent of iodine. Actions and Uses. — lodostarine-Roche is used as a substitute for the inorganic iodides. See preceding article, Iodized Fats and Fatty Acids. Dosage. — The same as that of potassium iodide. Marketed in the form of tablets only. Manufactured by F. Hoffmann-LaRoche & Co., Basle, Swizterland (Hoffmann-LaRoche, Inc., Nutley, N. J., distributor). U. S. patent 982,656 (Jan. 24, 1911; expired). U. S. trademark 87,996. Tablets lodostarine-Roche, 0.25 Cm. Chocolate Tablets lodostarinc-Roche : Each contains iodostarine-Roche equivalent to iodine, 0.01 Gm. This dosage form is used only for prophy- laxis against goiter and for the treatment of simple goiter. Iodostarine-Roche is a white, crystalline solid, odorless and tasteless. It is insoluble in water; slightly soluble in cold alcohol; soluble in warm alcohol, ether, chloroform, benzene and carbon disulfide. It is permanent in the air. It melts at 48 to 49 C. ; at a higher temperature it decomposes with evolution of iodine. To about 1 Gm. of iodostarine-Roche, accurately weighed, add 50 cc. of half-normal potassium hydroxide in methyl alcohol. Heat for two hours under a reflux condenser. Remove the condenser, boil off the alcohol, taking care to avoid loss by bumping, and transfer the residue to a separator, using at first warm water, but finally a little diluted nitric acid to insure complete transfer of the iodide to the separator. Cool and add 50 cc. of ether and sufficient diluted nitric acid to decom- pose the soap. If the solution becomes yellow from liberation of iodine add a little sodium sulfite to reduce the iodine. Shake thoroughly and draw off the acid layer through a wetted filter into a 500 cc. flask. Wash the ether in the separator with three separate portions of water of 25 cc. each, adding these through the filter to the acid solution in the flask, warm to expel dissolved ether, cool, and add 5 cc. of concentrated nitric acid and, at once, 25 cc. of tenth-normal silver nitrate. Titrate the excess of silver with tenth-normal potassium sulfocyanate, using ferric ammonium sulfate as indicator: the volume of tenth-normal silver nitrate used indicates not less than 47.5 per cent of iodine. LIPIODOL-LAFAY.— Iodized Poppy-Seed Oil 40 per cent. — An iodine addition product of poppy-seed oil containing 39 to 41 per cent of iodine (0.54 Gm. of iodine per cc.) in organic combination. IODINE 257 Actions and Uses. — Lipiodol-Lafay is used as a substitute for inorganic iodides; and as a contrast medium in roentgenog- raphy. See preceding article, Iodized Fats and Fatty Acids. In subarachnoid injection for roentgen examination, lipiodol radiologique descendant is used for the recognition of intra- dural tumors. Dosage. — From 1 cc. to 5 cc. (15 to 75 minims) or more according to the uses to which it is to be put. Manufactured by Andre Guerbet & Cie, Paris (E. Fougera & Co., New York, distributor). No U. S. patent. U. S. trademark 196,499. Ampcmles Lipiodol-Lafay, 1 cc. Ampoules Lipiodol-Lafay, 2 cc. Ampoules Lipiodol-Lafay, 3 cc. Ampoules Lipiodol-Lafay, 5 cc. Capsules Lipiodol-Lafay, 0.5 Gm.: Each gelatin capsule contains lipiodol-Lafay, equivalent to 0.2 Gm. of iodine. Dosage: Two to five capsules daily after meals. Lipiodol Radiologique Descendant. Tablets Lipiodol Calcium-Lafay : Each tablet contains a calcium salt of the iodized fatty acids of lipiodol-Lafay 0.1 Gm. (equivalent to 0.04 Gm. of iodine) incorporated in a base composed of sugar, acacia and cacao, and flavored with vanillin. Dosage: Two to five tablets daily. Lipiodol-Lafay is a thick, viscous oily liquid, having an alliaceous odor and an oleaginous taste and insoluble in water. On exposure to air and sunlight it decomposes, turning a dark brown color. Specific gravity at 20 C., from 1.340 to 1.350. Boil 0.5 cc. of lipiodol-Lafay and 10 cc. of alcoholic solution of potassium hydroxide (1 in 10), in a porcelain dish for about five min- utes, evaporate the liquid on a water bath and ignite the residue. Dissolve the residue in 10 cc. of water, filter the solution, add 5 cc. of hydrochloric acid to the filtrate, then add chloroform and a few drops of chlorine water and agitate: the chloroform solution is violet. Dis- solve 1 cc. of lipiodol-Lafay in 10 cc. of chloroform and add a few drops of phenolphthalein solution and 0.3 cc. of tenth-normal sodium hydroxide solution: the liquid becomes red (limit of acidity). Mix 10 cc. of lipiodol-Lafay with 50 cc. of petroleum benzin: a transparent liquid results. Boil about 1 cc. of lipiodol-Lafay with 10 cc. of nitric acid and 0.5 Gm. of silver nitrate, cool, add 25 cc. of water, collect the precipi- tate formed on a filter paper, wash free from the excess of silver nitrate; puncture the filter, collect its contents in a glass stoppered flask, treat with 50 cc. of stronger ammonia water, agitate thoroughly and allow to stand for one hour. Filter off the insoluble silver iodide; treat the filtrate with 15 cc. potassium iodide solution, and remove the excess of ammonia by evaporation on a steam bath: no opalescence results (absence of chlorine compounds). Ignite about 1 Gm. accurately weighed; the residue does not exceed 0.01 per cent. Transfer about 0.35 Gm., accurately weighed, to a bomb tube; determine the iodine content by the Carius method: the amount of iodine found is not less than 39 per cent nor more than 41 per cent. LIPIODOL RADIOLOGIQUE ASCENDANT.— Iodized Poppy-Seed Oil 10 per cent. — An iodine addition product of poppy-seed oil containing 9.8 to 11.2 per cent of iodine (0.11 Gm. of iodine per cc.) in organic combination. Actions and Uses. — Lipiodol radiologique ascendant is used for recognition of intradural tumors when it is desired to employ a contrast medium of lesser density than that of the spinal fluid. 258 NEW AND NONOFFICIAL REMEDIES Dosage. — From 1 to 2 cc, previously brought, with the syringe, to a temperature of 40 C. Manufactured by Andre Guerbet & Cie., Paris (E. Fougera & Co., New York, distributor). No U. S. patent. U. S. trademark 196,499. Lipiodol radiologique ascendant is a yellow, oily liquid, having an alliaceous odor and an oleaginous taste, insoluble in water. On exposure to air and sunlight it decomposes, turning a brown color. Specific gravity at 20 C, from 0.99 to 1. Lipiodol radiologique ascendant conforms to the tests for identity and purity, ash and assay as described under lipiodol-Lafay, except that the iodine content found is not less than 9.8 per cent nor more than 11.2 per cent. LIPOIODINE-CIBA. — Ethyl diiodobrassidate C2iH39la COOCCaHs), the ethyl ester of diiodobrassidic acid CHs. (CH2)7.CHI.CHL(CH2)ii.COOH, containing 41 per cent of iodine. Actions arid Uses. — Lipoiodine-Ciba is used as a substitute for the inorganic iodides and as a contrast medium for roent- genologic work. See preceding article, Iodized Fats and Fatty Acids. Dosage. — From 0.3 to 0.6 Gm. (5 to 10 grains), or in acute cases from 1.2 to 1.8 Gm. (20 to 30 grains). Lipoiodine-Ciba tablets should be masticated before swallowing. For diagnostic work, from 5 to 20 cc. of lipoiodine-Ciba diagnostic, as determined by the extent of the field to be investigated. Manufactured by the Society Chemical Industry in Basle, Switzer- land (the Ciba Company, Inc., New York, distributor). U. S. patent 1,024,171 (April 23, 1912, expired). U. S. trademark, 81,554. Lipoidine-Ciba Diagnostic, 10 cc. bottle: A 60 per cent solution of lipoiodine-Ciba in sesame oil. Tablets Lipoiodine-Ciba, 0.3 Gm. (Uncoated). Lipoiodine-Ciba crystallizes in white, odorless and tasteless needles, melting at Z7 C. It is insoluble in water, slightly soluble in alcohol, and very soluble in fatty oils, ether and benzene. Lipoiodine-Ciba is decomposed by exposure to direct light. The iodine content of lipoiodine-Ciba may be determined by the method of H. Baubigny and G. Chavanne {Compt. rend. Acad. d. sc. Paris 136:1197, 1199; Chem. Zentralbl. 3:69, 1903). ORIDINE. — The calcium salt of the iodized fatty acids of cottonseed oil. It contains from 23 to 25 per cent of iodine in organic combination. Actions and Uses. — Oridine is used as a substitute for the inorganic iodides. See preceding article, Iodized Fats and Fatty Acids. Dosage. — The iodine content of oridine 1 Gm. is approxi- mately equivalent to sodium iodide 0.28 Gm. and to potassium iodide 0.31 Gm. When used for the prophylaxis of goiter, 0.01 to 0.03 Gm. per day is given until 40 doses have been taken. IODINE 259 Manutactured by Eli Lilly and Co., Indianapolis. No U. S. patent. U. S. trademark 185,838. Oridine Tablets: Each contains oridine, equivalent to iodine 0.01 Gm. This dosage form is used only for prophylaxis against goiter and for the treatment of simple goiter. Oridine is a light brown powder, almost odorless and tasteless. It is almost insoluble in water, benzene, ether and alcohol; slightly soluble in chloroform and carbon tetrachloride. Mix oridine, 1 Gm. with water 20 cc. and filter: the filtrate becomes but slightly opalescent on the addition of silver nitrate solution (soluble iodides). Mix about 0.5 Gm. of oridine, accurately weighed, in a nickel cru- cible with a mixture of powdered sodium hydroxide 4 parts and potas- sium nitrate 1 part, and heat until fusion has been completed. Cool and dissolve the fused mass in 150 cc. of water, warming to hasten solution; filter into a 400 cc. beaker and wash well. Add 25 cc. of tenth-normal silver nitrate (the amount of silver is "k" in the formula below) ; then add slowly, with stirring, nitric acid until acid in reac- tion to litmus paper. Filter the solution through a weighed Gooch crucible, wash and titrate the excess silver nitrate in the filtrate with tenth-normal potassium sulfo-cyanate (the amount of silver iri the filtrate is "a"). The precipitate in the Gooch crucible (consisting mainly of silver iodide with some silver chloride) is further washed with 3 portions of alcohol, then ether, dried at 100 C. and weighed ("w"). The amount of iodine can be calculated according to the formula. .7527 w + a — k 293 where w equals combined weight of silver iodide and silver chloride, x equals weight of silver iodide and (w-x) equals, weight of silver chloride : by this method oridine contains not less than _ 23 per cent nor more than 25 per cent of iodine. (Chlorine is used in the manu- facture of oridine so that the finished product contains from 1 to 3 per cent of combined chlorine.) RIODINE (Astier). — A 66 per cent solution in oil of an iodine addition product of castor oil. Riodine (Astier) contains about 17 per cent of iodine. Actions and Uses. — Riodine (Astier) is used as a substitute for the inorganic iodides. See preceding article, Iodized Fats and Fatty Acids. Dosage. — From 0.4 to 1.2 Gm. (6 to 18 grains) per day, in pearls, taken after meals. Supplied only in the form of pearls. Manufactured by Dr. P. Astier Laboratories, Paris, and Gallia Labora- tories, Inc., New York, American licensees and distributors). No U. S. patent. U. S. trademark 86,974. Riodine Pearls, 0.2 Gm. (3.1 grains). Riodine (Astier) is prepared by treating castor oil with hydrogen iodide. Riodine (Astier) is an oil-like liquid, light amber in color, having a faint alkaline reaction. It is insoluble in water; soluble in alcohol, chloroform and ether. When heated, it is decomposed and purple vapors of iodine are given off. When heated with alcoholic potash, riodine (Astier) is saponified and potassium iodide formed. STEARODINE. — Calcium lodostearate. — Ca[CH3(CH2)7 CHI(CH2)8C02]2. — It contains from 26 to 28 per cent of iodine in organic combination. 260 NEW AND NONOFFICIAL REMEDIES Actions and Uses. — Stearodine is used as a substitute for the inorganic iodides. See preceding article, Iodized Fats and Fatty Acids. Dosage. — For prophylaxis of goiter, 0.01 Gm. weekly or biannual series of six weeks' treatment consisting of 0.01 Gm. daily. Manufactured by Parke, Davis & Co., Detroit. No U. S. patent. U. S. trademark 222,580. Stearodine Tablets: Each contains stearodine, equivalent to 0.01 Gm. of iodine. This dosage form is used only for prophylaxis against goiter and for the treatment of simple goiter. Stearodine is a cream colored solid, almost odorless, insoluble in water, soluble in chloroform, ether and benzin. When stearodine is agitated with diluted nitric acid, the filtrate responds to tests for calcium. When a small quantity of stearodine is warmed with strong sulfuric acid, violet vapors of iodine are evolved. Agitate about 1 Gm. stearodine with diluted nitric acid: the filtrate is not rendered distinctly turbid by the addition of silver nitrate solu- tion (absence of inorganic iodide). Mix about 0.1 Gm. of stearodine, weighed accurately, with 2 Gm. of sodium hydroxide in a nickel crucible and fuse the mixture gently. Allow the fusion to cool somewhat; add 8 Gm. of fusion mixture (sodium carbonate, potassium carbonate and potassium nitrate) and heat strongly until a clear liquid results. Allow the fusion to cool and dis- solve_ the mass in 250 cc. of water; add 30 cc. sodium hypochloride solution containing 2.5 per cent available chlorine; after five minutes acidify with an ^excess of phosphoric acid and heat until all free chlorine has been expelled; add an excess of sodium iodide and titrate the free iodine with tenth-normal sodium thiosulfate: each cubic centimeter of tenth-normal sodium thiosulfate consumed corresponds to 0.0126 Gm. of iodine; the iodine content found is not less than 26 per cent and not more than 28 per cent. CALCIUM lODOBEHENATE. — Calcium Monoidobe- henate. — "Consists principally of calcium monoiodobehenate [(C2iH42lCOO)2Ca] and contains, when dried to constant weight at 100° C, not less than 23.5 per cent of I." U. S. P. For standards see the U. S. Pharmacopeia under Calcii lodobehenas. Actions and Uses. — Calcium iodobehenate is used as a sub- stitute for the inorganic iodides. See preceding article, Iodized Fats and Fatty Acids. Dosage. — From 1 to 3 Gm. (15 to 45 grains) daily. Sajodin. — A brand of Calcium lodobehenate-U. S. P. Manufactured by Winthrop Chemical Co., Inc., Nev, York. U. S. patent 839,509 (Dec. 25, 1906; expired). U. S. trademark 61,730. Sajodin Tablets, 1 grain, Sajodin Tablets, 8 grains. IODIZED QUINOLINE DERIVATIVES CHINIOFON (See under Chiniofon Powder). VIOFORM (See under Iodine Dusting Powders). IODINE 261 WATER-SOLUBLE IODINE COMPOUNDS FOR INTRA- VENOUS PYELOGRAPHY Satisfactory roentgen pictures of the urinary tract may be secured by the intravenous injection of soluble iodine com- pounds of low toxicity, which are rapidly excreted by the urine. Several organic compounds are now available for this use. Sodium iodide, in the necessary dose, is too toxic for intra- venous injection. The organic compounds may also be used for ureteral retrograde pyelography. DIODRAST.— 3.5-^nodo-4-pyridone-A^-acetic acid anddieth- anolamine. — C5H20NLo.CH2.COOH4-NH(CH2CH20H)2. — A mixture or a loose combination (in solution) of diethanolamine, NH(CH2CH:OH)2 and 3,5-(/nodo-4-pyridone-A^-acetic acid, C5H2OHNI2CH2.COOH in equimolecular quantities. Diodrast contains approximately 49.8 per cent of iodine. Actions mid Uses. — Diodrast is proposed as a contrast agent for intravenous urography. Local reactions about the site of injection are said usually not to occur or to be very mild when they are observed ; systemic reactions occur occasionally. The latter consist chiefly of flushing of the skin with a sense of warmth; less often transient nausea, vomiting, erythematous eruptions, respiratory distress and cyanosis may occur. These side effects usually subside within a few minutes to an hour or so without special therapy, but the skin eruptions may rarely persist for several days. In animals, diodrast in doses equivalent by weight to those used clinically has been found to lower the blood pressure for a period of about two hours ; this slowly returns to normal and may be followed by a secondary rise ; at the same time, respiration is stimulated. These actions have been reported also to occur in the human being. Fasting and dehydration of patients preliminary to injec- tion of the drug are widely employed. The optimum time for taking roentgenograms varies between five and fifteen minutes after injection in individuals with normal kidney function (usually one exposure is made after ten minutes and a second after a further interval of ten or fifteen minutes). When renal function is impaired, this interval is proportionately longer (thirty minutes or more). Pressure over the bladder is employed by some clinicians ; this is released immediately before the first exposure and is replaced until the next. The use of the drug is contraindicated in patients with severe liver dis- orders, nephritis, tuberculosis or hyperthyroidism, and great care must be exercised in cases of uremia. Preliminary renal and hepatic function tests are advisable in suspected cases. Caution should be exercised in cases in which a reduction in blood pressure would be dangerous or otherwise undesirable. Dosage. — Twenty cc, of a solution containing 7 Gm. of diodrast, previously warmed to body temperature, is injected slowly, usually into the cubital vein. Children are given 262 NEW AND NONOFFICIAL REMEDIES correspondingly smaller doses. Diodrast is administered intra- venously in the form of an aqueous solution; each cubic centi- meter contains 0.35 Gm. Manufactured by Winthrop Chemical Co., Inc., New York. U. S. patent and trademark applied for. Diodrast Sterile Solution (35 per cent, weight /volume), 10 cc. size ampule: 10 cubic centimeters contains diodrast 3.5 Gm. Diodrast Sterile Solution (35 per cent, weight /volum-e, 20 cc. size ampule: 20 cubic centimeters contains diodrast 7.0 Gm. Diodrast responds to the following identity tests: Dilute about 10 cc. of diodrast solution with an equal volume of water, add an excess of diluted hydrochloric acid; collect the liberated 3,5-diiodo-4- pyridone-A^'-acetic acid on a filter paper, wash and dry at 100 C. : it melts with decomposition between 245 and 249 C. (the melting point bath previously heated to 200 C.) (Save the filtrate.*) Transfer about 0.1 Gm. of the resultant acid to a small hard glass test tube contain- ing a piece of sodium (about the size of a pea), previously melted; after the first violent action has ceased, heat until the contents of the test tube are decomposed: vapors of iodine are evolved; the tube and contents are allowed to cool; add 10 cc. of water: boil the mixture for a few minutes; filter through paper and divide into two portions; to one portion add 1 cc. of concentrated nitric acid, boil, cool and add 1 cc. of _ silver nitrate solution: a curdy yellow precipitate results, insoluble in an excess of stronger ammonia water; to the other portion add a few drops of fresh ferrous and ferric sulfate solutions, heat to nearly boiling and carefully neutralize with diluted hydrochloric acid: a finely divided blue precipitate results. Concentrate the original filtrate frorn the foregoing,* cool in ice water, filter, evaporate to syrupy consistency, add 5 cc. of alcohol, neutralize the mixture care- fully with normal sodium hydroxide using litmus as an indicator, filter and increase the volume of the filtrate to about 10 cc. with absolute alcohol, add 1 Gm. of trinitrophenol (picric acid), heat to boiling and finally cool in ice water; collect the resulting J/ethanolamine trinitro- phenolate on a filter paper, recrystallize from alcohol and dry in a desic- cator over sulfuric acid under a partial vacuum: it melts at 245 to 249 C, with decomposition (the melting point bath previously heated to 200 C). Dissolve about 1 Gm. of the resultant acid in 1.5 cc. of a 10 per cent solution of sodium hydroxide and make up to a volume of 3 cc: a clear colorless solution results. To the foregoing solution add 7 cc. of water and an excess of diluted hydrochloric acid, filter, and divide the filtrate into two portions; to one portion add 1 cc. of chloroform and 0.1 cc. of ferric chloride solution: no coloration is imparted to the chloroform layer (absence of free inorganic iodides); to the other por- tion add 1 cc. of barium chloride solution: no turbidity results (sulfate j. Z?iiodo-4-pyridone-A''-acetic acid, a component of diodrast, responds to the following tests for identity and purity. Dtiodo-4-pyTidone-JV-acetic acid occurs as a white crystalline odorless powder; slightly soluble in water; practically insoluble in organic solvents. It melts at 245 to 249 C, with decomposition (the melting point bath previously heated to 200 C^.). Z?nodo-4-pyridone-A/'-acetic acid responds to identity and purity tests previously described under diodrast, except those dealing with diethanol- amine. Dry about 1 Gm. of diodrast acid component, 3,5-c?uodo-4-pyridone-Ar- acetic acid, accurately weighed, to constant weight at 100 C.: the loss in weight does not exceed 1 per cent. Transfer about 1 Gm. of Diodrast acid component, accurately weighed, to a 500 cc. Kjeldahl flask and determine the nitrogen content according to the official method described in Official and Tentative Methods of Analysis of the Asso- ciation of Official Agricultural Chemists, third edition, page 20, chapter 2, paragraph 22: the percentage of nitrogen corresponds to not less than 3.3, nor more than 3.6 when calculated to the dried substance. Transfer about 0.5 Gm. of the diodrast acid component to a Parr IODINE 263 sulfur bomb; determine the iodine content by the Lemp and Broderson Method (/. A. Chem. Soc. 39: 2069): the amount of iodine found corresponds to not less than 62.3 per cent, nor more than 63.2 per cent when calculated to the dried substance. DIODRAST STERILE SOLUTIONS Diodrast solution is prepared by neutralizing 3,5rftiodo-4-pyridone-A/^- acetic acid in water with an equimolecular quantity of diethanolamine. The mixture thus formed in solution (not isolated in solid form) is very soluble in water. Diodrast solution occurs as a clear and nearly colorless liquid. It is neutral to litmus. Diodrast solution is incompatible with mineral acids. The specific gravity is from 1.180 to 1.190 at 25 C. Place 10 cc. of diodrast solution, accurately measured, in a suitable tared platinum dish, evaporate to dryness on the steam bath and ignite: the residue does not exceed 0.10 per cent. Transfer 10 cc. of diodrast solution, accurately measured, to a suit- able glass stoppered Erlenmeyer flask, neutralize with normal hydro- chloric acid, adding a very slight excess; cool the flask and contents to about 5 C, collect the precipitate formed in a tared Gooch crucible, wash with cold diluted acid solution, dry to constant weight at 100 C: the weight of 3,5dnodo-4-pyridone-A''-acetic acid obtained corresponds to not less than 2.7 Gm. nor more than 2.8 Gm. The free acid corre- sponds to the standards given under diodrast. Note. — The assay by precipitation with a mineral acid is roughly approximate; it is important that as nearly exactly the specified amount of diodrast solution as possible be used, because the solubility of the 3,5-d!iodo-4-pyridone-iV'-acetic acid precipitate varies. This assay method of standardization is therefore at best approximate, and must be con- sidered tentative until such time as more accurate analytic procedure is available. HIPPURAN.— Sodium ortho-iodohippurate.— CeHJ.CONH. CH2COONa+2H20. The sodium salt of o-iodohippuric acid. Hippuran contains 38.8 per cent of iodine, when calculated to the dried substance. Actions and Uses. — Hippuran is proposed for use as a radi- opaque agent for intravenous, oral or retrograde urography. When used by the intravenous route, irritation at the site of injection is stated not to occur and systemic reactions appear to be unusual ; a sensation of generalized warmth is the most common side-effect; nausea occurs occasionally and vomiting rarely. Fasting and dehydration of patients preliminary to administration of the drug are usually employed. Pressure over the bladder region is employed by some clinicians ; this is released immediately before the first exposure and is replaced until the next. Ordinarily the first film is exposed about ten minutes after injection and two subsequent pictures are taken at fifteen or twenty minute intervals. In case excretion is delayed, later exposures may be necessary. Results with oral administration of the drug are less satis- factory but a sufficiently high percentage of successful pictures appear to be obtained to make this method worthy of trial in occasional cases in which intravenous or retrograde urography is not feasible. The somewhat objectionable taste of the com- pound usually does not militate against its ingestion. Toxic effects after oral administration have not been reported. Pic- tures are taken 60, 90, 120 and 150 minutes after oral adminis- 264 NEW AND NONOFFICIAL REMEDIES tration. The use of moderate compression over the bladder region is recommended in the intervals between exposures. While the iodine in hippuran is firmly bound, the compound should nevertheless be used with caution if at all in patients with hyperthyroidism and tuberculosis. The use of the drug is contraindicated in severe liver disorders, nephritis and uremia. In suspected cases preliminary hepatic and renal function tests should be employed. Satisfactory visualization has been reported with hippuran when employed by the retrograde method for urethrograms, cystograms or pyelograms. There is said to be little or no tissue irritation with effective concentrations. Dosage. — For intravenous use, 25 cc. of a solution containing 12 Gm. of hippuran, previously warmed to body temperature, is injected into the cubital vein. Young children are given proportionately smaller doses. For oral use, 12 Gm. of hippuran is dissolved in 75 cc. of simple syrup. For children, 10 Gm. is employed. For retrograde use, hippuran is employed in 15 to 20 per cent solution for pyelography or 3 to 5 per cent solution for cystography. The solution may be made either by diluting the ampule solution with sterile distilled water or by dissolving the crystals in distilled water, filtering and sterilizing by heat. Manufactured by Mallinckrodt Chemical Works, St. Louis. U. S. patent and trademark applied for. Hippuran (Crystals) 12 Gm. vial. Stenle Solution Hippuran 25 cc. size: 25 cc. contains 12 Gm. hippuran. Hippuran occurs as a white, crystalline powder, possessing a faint odor and an alkaline taste; very soluble in water, freely soluble in ethyl alcohol and soluble in dilute alkali. An aqueous solution is neutral or faintly alkaline to litmus. Fuse about 0.2 Gm. of hippuran with 2 Gm. of powdered sodium hydroxide: it decomposes with the evolution of iodine vapors and ammonia. Dissolve about 0.5 Gm. of hippuran in 100 cc. of water, add an excess of diluted hydrochloric acid; collect the resultant o-iodo- hippuric acid on a filter, wash and dry at 110 C.: it melts at 171 to 174 C.; to 1 cc. of the foregoing filtrate add 10 cc. of uranyl zinc acetate solution: a yellow precipitate results. Transfer about 0.5 Gm. of hippuran to a glass-stoppered cylinder, add 25 cc. of a diluted nitric acid (one part diluted nitric acid and 5 parts water), shake for five minutes, filter: the filtrate yields no distinct opalescence on the addition of 2 cc. silver nitrate solution (absence of inorganic halides). Dissolve about 0.5 Gm. of hippuran in 50 cc. of water, add 5 cc. diluted hydrochloric acid, filter: separate portions of 10 cc. each of the filtrate yield no turbidity on the addition of 1 cc. of barium chlo- ride solution (sulfate); no coloration or precipitation on saturation with hydrogen sulfide {salts of heavy metals). Dry about 1 Gm. of hippuran, accurately weighed, to constant weight at 100 C. : the loss in weight is not more than 10 per cent nor less than 6 per cent. Er>il about 1 Gm. of hippuran, accurately weighed, with 10 cc. of benzene for fifteen minutes, replacing the evaporated liquid if necessary, d.cant the supernatant liquid through filter paper and wash filter with 10 cc. and 5 cc. portions, respectively; evaporate the combined filtrates to dryness in a tared beaker and dry to constant weight at 100 cc. : the residue does not exceed 0.2 per cent (uncombined o-iodohippuric acid). Transfer about 0.5 Gm. of hippuran, accurately weighed, to a 500 cc. Kjeldahl flask; determine the nitrogen content according to the official method described in the Official and Tentative IODINE 265 Methods of Analysis of the Association of Official Agricultural Chem- ists, third edition, page 20, chapter 2, paragraph 22: the percentage of nitrogen corresponds to not less than 4.1 per cent, nor more than 4.4 per cent when calculated to the dried substance. Weigh accurately about 1 Gm. of hippuran in a tared platinum dish, add 5 cc. of sulfuric acid, heat cautiously while fumes of iodine and sulfur trioxide are evolved; repeat twice, using portions of 1 cc, each of sulfuric acid; add about 0.5 Gm. of ammonium carbonate; ignite to constant weight, and weigh as sodium sulfate: the sodium found corresponds to not less than 6.8 per cent nor more than 7.3 per cent, when calcu- lated to the dried substance. Transfer about 0.5 Gm. of hippuran to a Parr sulfur bomb; determine the iodine content by the Lemp- Broderson method (/. Am. Chcm. Soc. 39: 2069): the amount of iodine found corresponds to not less than 38.5 per cent nor more than 39 per cent, when calculated to the dried substance. NEO-IOPAX.— Neo-Iopax Sodium.— D /sodium AT-methyl- 3 : 5-c?iiodo-4-pyridoxyl-2 : 6-(/zcarboxylate. — NaOOC.CsONL'. CHsCOONa. The cf/sodium salt of iV-methyl-3 : 5-c/iiodo-cheli- damic acid. Neo-Iopax contains 51.5 per cent iodine. Actions and Uses. — Neo-iopax is used as a contrast medium in intravenous urography. It has advantages over iopax in that a smaller dose is required, the volume of solution injected is much less and the drug is excreted in the urine in relatively higher concentration. Clinical reports indicate that systemic reactions occur uncommonly and are usually mild and fleeting. In some cases there is more or less severe pain in the arm radiating to the shoulder ; usually this disappears on completion of the injection but in a small percentage of cases it may persist for a variable period. The pain may usually be relieved by local applications of heat and the administration of an analgesic when necessary. If only anatomic information is desired, it is usually sufficient to take a single roentgenogram from twenty to thirty minutes after injection. In other cases, a series of roentgeno- grams are taken at intervals of ten, thirty and fifty minutes after injection. Before the second picture is taken, the bladder is emptied in order that the shadow of the drug in the bladder may not obscure the lower parts of the ureters. If the first plates show that but little of the drug has been excreted, it is presumed that the kidneys are functioning poorly, and several hours should be allowed to elapse, during which plates should be made at intervals. Impairment of renal function will allow but poor concentration of the drug ; many hours are then required for its excretion. The use of the drug is contra- indicated in patients with severe liver disorders, nephritis, tuber- culosis or hyperthyroidism, and great care must be exercised in cases of uremia. Caution must also be exercised in patients with any severe systemic disease. Preliminary liver and kidney function tests are advisable in suspected cases. Dosage. — Twenty cc. of solution containing 15 Gm. of neo- iopax previously warmed to body temperature is injected intra- venously, very slowly, into the cubital vein. Children are given correspondingly smaller doses. Manufactured by Schering Corporation, Bloomfield, New Jersey. U. S. patent applied for. U. S. trademark 297,925. 266 NEW AND NONOFFICIAL REMEDIES Ampoule Solution Neo-Iopax, 20 cc: Each ampule contains neo-iopax, 15 Gm., dissolved in sviiEcient sterile distilled water to make 20 cc. Neo-Iopax occurs as a white, crystalline, odorless powder; very soluble in water; insoluble in acetone, benzine, chloroform, ether and purified petroleum benzine. An aqueous solution is neutral to litmus. Dissolve about 0.5 Gm. of neo-iopax in 100 cc. of water, add an excess of diluted hydrochloric acid; collect the liberated A'^-methyl-S : 5-duodo-4-pyridoxyl-2:6-c?/carboxylic acid on a filter, wash and dry in a desiccator over sulfuric acid under a partial vacuum: it melts at about 174 C., with decomposition; heat the remainder of the resultant acid at its decomposition temperature (about 175 to 180 C.) until no further evolution of gas is noted: the residual substance, .V-methyl- 3:S-diiodo-4-pyridone, thrice recrystallized from water, melts at 214 C.; to 1 cc. of the foregoing filtrate add 10 cc. of uranyl zinc acetate solu- tion: a yellow precipitate results. Dissolve about 0.5 Gm. of neo-iopax in 50 cc. of water, add an excess of hydrochloric acid, filter through paper and divide into two portions; to one portion add 1 cc. of chloroform and 0.1 cc. of ferric chloride solution: no coloration is imparted to the chloroform layer (absence of free inorganic iodide) ; saturate the other portion with hydrogen sulfide: no coloration or precipitation results (salts of heavy metals). Dry about 1 Gm. of neo-iopax, accurately weighed to constant weight at 100 C.: the loss in weight does not exceed 2 per cent. Transfer aboiit 1 Gm. of neo-iopax, accurately weighed, to a 500 cc. Kjeldahl flask, and determine the nitrogen content according to the official method described in Official and Tentative Methods of Analysis of the Asso- ciation of Official Agricultural Chemists, third edition, page 20, chapter 2, paragraph 22: the percentage of nitrogen corresponds to not less than 2.7 per cent, nor more than 2.9 per cent when calculated to the dried substance. Weigh accurately about 0.5 Gm. of neo-iopax in a tared platinum dish, add 10 cc. of sulfuric acid, gently heat while fumes of iodine and sulfur trioxide are evolved, repeat, using two portions of sulfuric acid, respectively, ignite, cool and weigh as sodium sulfate: the sodium found corresponds to not less than 9.2 per cent nor more than 9.4 per cent when calculated to the dried substance. Transfer about 0.2 Gm. of neo-iopax to a Parr sulfur bomb; deter- mine the iodine content by the Lemp and Broderson Method (Journal of the American Chenvical Society 39: 2069): the amount of iodine found corresponds to not less than 51 per cent nor more than 53 per cent when calculated to the dried substance. SKIODAN.— Skiodan Sodium.— Methlodal.— CHsI.SOsNa. — The sodium salt of mono-iodo-methanesulfonic acid. Skio- dan contains 52 per cent iodine. Actions and Uses. — Skiodan is proposed as a therapeutically indifferent medium for roentgenography, especially for visual- ization of the urinary tract either by intravenous injection or by direct injection into the renal pelvis through a ureteral catheter. It has been reported that skiodan exerts a diuretic action, most marked during the first half hour after intravenous injection. Excretion studies show that within a few minutes after intravenous injection the concentration of skiodan in the urine reaches a maximum of from 4 to 6 per cent (corresponding to from 2 to 3 per cent of iodine). Usually, 75 per cent is eliminated in three hours, more than 90 per cent in ten hours, and the remainder within about twenty-four hours. Dosage. — For intravenous urography, skiodan is administered in sterile aqueous solution (from 20 to 40 Gm. in 100 cc), the average dosage for adults being about 2 Gm. for each 15 pounds of body weight ; for retrograde pyelography an aqueous solution of skiodan (from 10 to 20 Gm. in 100 cc.) is injected through IRON AND IRON COMPOUNDS 267 a ureteral catheter in the renal pelvis. Cystograms may be made with 3 to 5 per cent solutions. Aqueous solutions of skiodan should be kept protected from light; they can be kept for a considerable time without impairment but should be resterilized before use. On the day before the intravenous injection of skiodan the patient is given a soft diet, with a cleansing enema in the evening. During the night the fluid intake is restricted as much as possible. Sterile Solution Skiodan (40 per cent by volume) : Each cubic centi- meter contains skiodan, 0.4 Gm. Tablets Skiodan, 1 Gm. Manufactured by Winthrop Chemical Co., New York. U. S. patent applied for. U. S. trademark 283,045. Skiodan occurs as a white, crystalline, odorless powder possessing a slight saline taste followed by a sweetish after-taste; it is very soluble in methyl alcohol, slightly soluble in ethyl alcohol, practically insoluble in acetone, benzene and ether; the aqueous solution is neutral to litmus; on exposure to light it decomposes, turning to a yellow color. Fuse about 0.5 Gm. of skiodan with 5 Gm. of powdered anhydrous sodium carbonate in a nickel crucible until decomposed: the crucible and contents are allowed to cool; dissolve the residue in 20 cc. of water; filter the mixture through paper and divide the filtrate into two portions. To one portion add an excess of diluted hydrochloric acid followed by the addition of a few drops of freshly prepared sodium nitrite solution and finally a few drops of chloroform and agitate the mixture: a deep violet color is assumed by the chloroform; to the other portion add a few drops of freshly prepared sodium nitroprusside solu- tion: a deep violet color results. To about 0.1 Gm. of skiodan dis- solved in 5 cc. of water, add an excess of acetic acid, followed by the addition of an equal volume of zinc uranyl acetate solution (prepared according to Barber and Kolthoff, J. A. C. S. 50: 1625, 1928): a yellow, crystalline precipitate results. Dissolve about 1 Gm. of skiodan in 25 cc. of water; separate portions of 5 cc. each yield no opalescence with 1 cc. of diluted nitric acid and 1 cc. of silver nitrate solution (inorganic iodide and chloride) ; no turbidity with 1 cc. of diluted hydrochloric acid and 1 cc. of barium chloride solution (sulfate) ; no coloration or precipitation on saturation with hydrogen sulfide {salts of heavy metals). When tested for arsenic according to the U. S. P. X, the product meets requirements for arsenic (p. 428, Arsenic Test). Dry about 1 Gm. of skiodan, accurately weighed to constant weight at 100 C. : the loss in weight does not exceed 1 per cent. Transfer about 0.3 Gm. of skiodan to a bomb tube; determine the iodine content by the Carius method: the amount of iodine found corresponds to not less than 51.9 per cent nor more than 52.3 per cent when calculated to the dried substance. Weigh accurately about 0.3 Gm. of skiodan in a tared platinum dish, add 5 cc. of sulfuric acid, gently heat while the fumes of iodine and sulfur trioxide are evolved, repeat twice, using two portions of 2 cc. of sulfuric acid each time, cool and weigh as sodium sulfate: the percentage of sodium corresponds to not less than 9.3 per cent, nor more than 9.5 per cent calculated to the dried substance. IRON AND IRON COMPOUNDS Iron is used in medicine: (1) in the form of metallic or elementary iron (reduced iron, U. S. P.) ; (2) in the ferrous or unoxidized form of combination — responding to tests for ferrous ions (ferrous carbonate in mass of ferrous carbonate and pill of ferrous carbonate, ferrous iodide in syrup of fer- 268 NEW AND NONOFFICIAL REMEDIES rous iodide, U. S. P.) ; (3) in the trivalent or oxidized form, the ferric compounds — responding to tests for ferric ions (ferric chloride in tincture of ferric chloride, U. S. P.) ; and (4) in the form of complex compounds of iron. Complex (masked or nonionic) iron compounds are those compounds of iron whose solutions do not respond to the ordi- nary tests for ferrous or ferric ions because in them the iron is part of a radical. Complex compounds of iron do not have the astringent taste of simple iron solutions. The permanence of these complex radicals differs widely ; while some, such as soluble ferric phosphate, N. F., and solution of peptonized iron, N. F., are converted to simple ionic iron by action of dilute acids, others resist treatment with strong acids or with alkalis. The complex iron compounds occurring naturally in animal and vegetable tissues (which are often termed food irons) belong generally to the more resistant class, while the complex iron compounds produced artificially are as a rule decomposed rather readily. There is, however, no sharp line of distinction between the natural complex iron compounds and the artificially produced ones, nor is there any good evidence that they differ in therapeutic action. Until a difference in their effects has been demonstrated, we may class together all complex iron compounds whose solutions are not decomposed into simple ionic iron by digestion at body temperature with 0.2 per cent hydrochloric acid and pepsin. (It should be emphasized that salts of iron which give the iron test directly are classed as inorganic iron, whatever their acid radicals may be, and that true iron albuminate and iron peptonate are inor- ganic iron compounds.) Actions and Uses. — Solutions of ferric iron are used exter- nally as styptics. Ferric solutions may be used for their astringent effects, internally, and as a gargle. The principal use of iron, however, is in the treatment of anemia and chlorosis. For this purpose, the ferrous salts are usually preferred to the ferric salts, as they are not so caustic and hence are less likely to disturb the stomach. Reduced iron, yielding ferrous chloride when dissolved in the stomach, acts as a ferrous compound, provided the hydrochloric acid in the gastric fluid is sufficient to permit solution. So far as the complex iron compounds are not decomposed by gastric digestion, they also are devoid of gastric effects; but, on the other hand, it has been claimed that certain hemoglobin-like compounds escape absorption alto- gether, Bunge supposed that only "organic iron" could be absorbed and assimilated by the body, the reputed action of inorganic iron being altogether indirect and due to its local effect on the alimentary canal. This theory was modified by Abderhalden to the effect that inorganic iron, while it could not be converted into hemoglobin, nevertheless, stimulated the conversion of "organic iron." Later work (Tartakowski), how- ever, seems to prove that inorganic iron is assimilated and converted into hemoglobin and thus far is therapeutically fully IRON AND IRON COMPOUNDS 269 equal to natural complex iron compounds, Whipple and his co-workers have shown that ferrous carbonate (in the form of Blaud's Pills) aids recovery from the anemia of repeated hem- orrhages. Starkenstein Hefftner-Heubner : (Handbuch der experimentelle Pharmakologie) reports that Reiman has shown that ferrous salts are effective in bringing about a reticulocyte response, hemoglobin and red blood cell increase in much smaller amounts than the ferric salts. 100 mg. of iron as ferrous salts daily were shown to be effective. A difference exists between the different iron preparations in their local irritant and astringent action, which is absent in most of the complex iron compounds. These local actions may be desirable in some cases and undesirable in others. This should mainly determine the selection of the particular iron preparation most suitable for each patient. Suitable diet (especially liver, kidney, meat and spinach) is sometimes more effective than the iron preparations, presumably by the cooperation of other factors ; for in pernicious anemia, liver extract that is practically iron- free is equally active. Simple Iron Salts FERROUS LACTATE.— Ferri Lactas.— Iron Lactate.— Ferrum Laclicum.— Fe(GH503)2-|-3HoO. — The ferrous salt of lactic acid. The salt contains approximately 19 per cent of metallic iron. Actions and Uses. — Ferrous lactate is a mild chalybeate, which, because of its feeble taste, may be taken without difficulty. Dosage. — From 0.06 to 1.3 Gm. (1 to 20 grains). Owing to its liability to oxidation, it is best prescribed in solutions con- taining much sugar. Syrup dissolves 1 Gm. in 120 Gm, (4 grains to the fluidounce). Ferrous lactate occurs in pale greenish-white crusts, consisting of srnall needle-shaped crystals or transparent green scales, having a slight, peculiar odor and a sweetish, ferruginous taste. It is slowly- soluble in about 40 parts of cold and in 12 parts of boiling water; almost insoluble in alcohol; freely soluble in a solution of an alkali citrate, yielding a green solution. When strongly heated, the salt froths, gives out dense, white, acid fumes, chars and finally leaves a brownish-red residue. The aqueous solution of the salt has a greenish-yellow color and a slightly acid reaction, and gives a deep blue precipitate with potassium ferricyanide, and a light blue one with potassium ferrocyanide. A 2 per cent aqueous solution of the salt should not yield more than a faint opalescence with a lead acetate solution (limit or absence of sulfate, chloride, citrate, tartrate and malate). The aqueous solution after acidulation with hydrochloric acid should not yield any precipitate or coloration when treated with hydrogen sulfide (foreign metals). The aqueous solution, acidulated with nitric acid, should not afford more than slight opalescence with barium chloride solution or with silver nitrate solution (limit of sulfate or chloride). If 25 cc, of a 2 per cent aqueous solution of the salt is mixed with 5 cc, of diluted sulfuric acid, the mixture boiled for a few minutes, an excess of sodium hydroxide solution added and the mixture filtered, the filtrate, when mixed with a few drops of alkaline cupric tartrate solution and boiled, does not yield a red precipitate (sugar). If a portion of the 270 NEW AND NONOFFICIAL REMEDIES salt is triturated with sulfuric acid, no offensive odor is developed (butyric acid), nor is any gas evolved (carbonate) and the mixture, after standing for some time, does not assume a brown color (sugar, gum or other readily carbanisable impurities). If from 1 to 1.5 Gm, of the salt is weighed and moistened with nitric acid and carefully ignited in a porcelain crucible it leaves a residue of ferric oxide, weighing not less than_ 27 per cent nor more than 27.8 per cent of the material taken: this residue does not have an alkaline reaction on litmus paper, nor yield anything soluble to water (foreign salts). Iron Lactate-Merck. — A brand of ferrous lactate-N. N. R. Merck & Co., Inc., Rahway, N. J., distributor. Xo U. S. patent or trademark. Complex Iron Salts GREEN IRON AND AMMONIUM CITRATES.— "Contains ferric citrate equivalent to not less than 14.5 per cent and not more than 16 per cent of Fe." U. S. P. For standards see the U. S. Pharmacopeia under Ferri et Ammonii Citrates Virides. Iron Citrate Green-P. D. & Co. — A brand of Green Iron and Ammonium Citrates-U. S. P. Actions and Uses. — See preceding article, Iron and Iron Compounds. Iron citrate green-P. D. & Co. is intended for intramuscular and hypodermic administration, it being claimed that because of the higher ammonium citrate content the use of this product is less painful and less liable to produce coagu- lation of proteins when injected than is produced with the pharmacopeia! iron and ammonium citrates. The Council is not convinced that the intramuscular or hypodermic administration of iron yields effects which differ from those obtained by the oral administration; however, the unsettled state of iron therapy and the rather large clinical use of iron by intramuscular or subcutaneous injection appears to justify the provisional acceptance of this preparation. Dosage. — From 0.015 Gm. (^4 grain) to 0.1 Gm. (1^ grains) administered intramuscularly or subcutaneously. Iron citrate green-P. D. & Co. is marketed in the form of solution only. Manufactured by Parke, Davis & Co., Detroit. No U. S. patent or trademark. Ampoules Iron Citrate Green-P. D. &■ Co., 54 grain: Iron citrate green- P. D. & Co., 0.015 Gm. (J4 grain); quinine and urea hydrochloride, 0.005 Gm.; distilled water, 1 cc. Ampoules Iron Citrate Green-P. D. & Co., ^ grain: Iron citrate green- P. D. & Co., 0.05 Gm, (^ grain); quinine and urea hydrochloride, 0.005 Gm.; distilled water, 1 cc. Ampoules Iron Citrate Green-P. D. & Co., l^z grains: Iron citrate green-P. D. & Co, 0.1 Gm. (IJ^ grains); quinine and urea hydrochloride, 0.005 Gm.; distilled water, 1 cc. SOLUTION OF FERRIC CHLORIDE.— "An aqueous solution containing ferric chloride (FeCla), corresponding to not less than 10 per cent and not more than 11 per cent of Fe. It contains not less than 3 per cent and not more than 5 per cent of HCl." V. S.P. ISACEN 271 For standards see the U. S. Pharmacopeia under Liquor Ferri Chloridi. Saf-T-Top 5% Ferric Chloride in 50% Glycerine Solution: A solution containing ferric chloride-U. S. P. and glycerin in equal parts, by weight: marketed in ampules having a capillary opening, and containing 2 and 15 CO. This form is intended for use as a neutralizing agent of the toxi- codendrol of poison ivy and poison sumac. It is applied externally. Prepared by Robert A. Bernhard, Rochester, N. Y. Complex Iron Salts — Hemoglobin Derivatives Hemoglobin is the coloring matter of the blood corpuscles and is the most important iron-containing compound of the body. It exists in venous blood as hemoglobin, sometimes called reduced hemoglobin, and in the lungs takes on oxygen in a loose chemical combination becoming oxyhemoglobin. Hemoglobin is obtained from oxyhemoglobin by the action of various reducing agents. When ingested, it is decomposed in the stomach, being con- verted into a protein, globin, and into hematin, an acid, non- albuminous substance, containing the iron of hemoglobin. The same decomposition is produced by heating in solution to 70 C, and by various chemical agents. It is doubtful whether hemo- globin is absorbed into the blood from the gastro-intestinal canal. Various preparations of hemoglobin have been put on the market. These are of two classes: (1) preparations consisting essentially of oxyhemoglobin, usually sold under the name ''hemoglobin"; (2) preparations derived by the action of reduc- ing agents on the blood, such as zinc and pyrogallol. They consist of reduced hemoglobin or of some modification of it. ISACEN.— Diacetyldihydroxyphenylisatin.— CCt < ( ) >OOCCHj The diacetyl derivative of dihydroxyphenylisatin. The com- pound resembles phenolphthalein in that the isatin group has sornewhat the same general grouping as that of the phthaleins ; unlike phenolphthalein, in isacen the two hydroxy radicals (of the two phenol groups) have been condensed with two acetyl groups. Actions and Uses. — Isacen passes through the stomach unchanged. When it reaches the intestine, a gradual splitting 272 NEW AND NONOFFICIAL REMEDIES off of dihydroxyphenylisatin takes place under the influences of the alkaline contents of the intestine. The dihydroxyphenylisatin thus produced is stated to be nontoxic, not to be absorbed, and to be excreted entirely through the feces. Neither dihydroxy- phenylisatin nor the acetyl compound isacen appears in the urine after administration of isacen. Isacen acts as a laxative or purgative, depending on the dosage employed. Dosage. — As a laxative, 0.005 Gm. (^2 grain) ; in cases of obstinate constipation, from 0.015 to 0.02 Gm. (^ to ^ grain). Isacen is supplied in the form of tablets only. Manufactured bj' Hoffmann-LaRoche, Inc., Nutley, N. J. U. S. patent 1,624,675 (April 12, 1927; expires 1944). U. S. trademark 200,220. Isacen Tablets 0.005 Gm. (Y12 grain). Isacen is a white, crystalline, odorless, tasteless powder. It is insoluble in water and dilute hydrochloric acid; slightly soluble in alcohol, very slightly soluble in ether. It melts at 241 to 242 C. Boil 0.1 Gm. of isacen with 3 cc. of sodium hydroxide solution; cool, dilute to 10 cc, with water: on the addition of a few drops of potassium ferricyanide solution (1 in 10) a cherry red color results. Boil 1 Gm. of isacen with 10 cc. of sodium hydroxide solution; cool and add an excess of diluted sulfuric acid: the odor of acetic acid develops. Dis- solve 1 Gm. of isacen in 20 cc. of glacial acetic acid and maintain at 100 C.: a clear solution results (limit of dihydroxyphenylisatin). Boil 1 Gm. of isacen with 50 cc. of distilled water: no odor develops. Cool the solution, add siifficient water to restore the volume of 50 cc; filter, and to 10 cc. of the filtrate add a few drops of silver nitrate solution; no opalescence is produced immediately (chloride). Transfer 2 Gm. of isacen to a glass stoppered cylinder, add 50 cc. of distilled water, shake for five minutes and filter through paper. To 25 cc. of the filtrate add one drop of phenolphthalein solution: on the addition of one drop of tenth-normal sodium hydroxide solution, a pink color results (limit of acid). Incinerate about 1 Gm. accurately weighed: the ash should not be more than 0.5 per cent. ISOPROPYL ALCOHOL.— Propan-2-ol.—CH3.CH(OH). CHs. — obtained by the reduction of acetone or, as a product in the petroleum industry, by the absorption of olefin gases con- taining propylene in sulfuric acid, and hydrolyzing the result- ing sulfuric acid esters. Actions, Uses and Dosage. — Isopropyl alcohol, because it is a solvent for creosote, is used in the removal of that substance from the skin as a prophylactic agent against creosote burns. Isopropyl alcohol has been recommended for the disinfection of the skin and of hypodermic syringes and needles. As it is said not to affect the potency of solutions of insulin, it has been employed as a disinfecting agent in connection with the administration of this agent. Until further data are available, isopropyl alcohol should not be relied on to destroy such spore- bearing organisms as Clostridium tetani, Clostridium Welchii or Bacillus anthracis. It is not potable and should not be given by mouth. Isopropyl alcohol is a clear, colorless, volatile liquid, having a charac- teristic odor and a slightly bitter taste, miscible with water in all pro- portions; also miscible with chloroform and ether. It is insoluble in salt KEPHRINE HYDROCHLORIDE 273 solutions and may be recovered from aqueous mixtures by salting out with sodium chloride, sodium hydroxide, etc. Specific gravity at 25 C. from 0.780 to 0.790. Refractive index at 20 C, from 1.3770 to 1.3780 Isopropyl alcohol is volatized at low temperatures and boils at from 81 to 83 C. It does not affect blue or red litmus paper previously moistened with water when diluted with an equal volume of water. Shake 20 cc. of isopropyl alcohol in a glass stoppered cylinder with 1 cc. of a freshly prepared solution of ammonio silver nitrate and allow to stand in diffused daylight for six hours: the mixture does not become more than faintly opalescent or acquire more than a faint brownish tint (aldehyde). To 5 cc. of isopropyl alcohol add 2 cc. of normal sodium hydroxide solution and 5 drops of a 1 per cent aqueous solution of sodium nitroprusside, mix thoroughly, finally make slightly acid with acetic acid: no purplish red color (acetone). Evaporate 100 cc. of isopropyl alcohol in a platinum dish on a water bath, and dry at 100 C. : the residue does not exceed 0.01 per cent. Saf-T-Top Isopropyl Alcohol, 98%: Isopropyl alcohol, 98 per cent, marketed in ampules having a capillary opening, and containing 2 and 15 cc. This dosage form is intended solely for the removal of creosote from the skin. Prepared by Robert A. Bernhard, Rochester, N. Y. KEPHRINE HYDROCHLORIDE.— Methylaminoaceto- catechol hydrochloride. — a-keto-^-methylainine-or^Ao-/>ara dihy- droxyethyl-benzene hydrochloride.— (OH)a CeHa COCHa NH (CHs) HCl. Kephrine hydrochloride is the monohydrochloride of a base resembling epinephrine (/a^z/o-methylaminoethanol- catechol) but differs in that kephrine possesses a ketone group in place of the secondary alcohol group of epinephrine. Actions and Uses. — Kephrine hydrochloride acts by constric- tion of the blood vessels. In comparison with epinephrine its action is less powerful, but the effects are more lasting. Kephrine hydrochloride is used only locally and will, as a rule, arrest capillary bleeding within two or three minutes. The hemostatic effects usually persist from one to two hours. As there is no appreciable absorption of kephrine hydrochloride into the blood stream, it does not have any noticeable effect on the blood pressure. Kephrine hydrochloride is not destroyed by blood alkali. Dosage. — Kephrine hydrochloride is marketed in the form of powder and suppositories; bandages and gauze impregnated with kephrine hydrochloride are also supplied. The selection of a suitable dosage form is governed by the anatomic or pathologic characteristics of the individual case. Manufactured by Chemosan Union, A. G., Vienna, Austria (Campbell Products, Inc., New York, distributor). No U. S. patent or trademark. Kephrine Hydrochloride Powder: Kephrine hydrochloride 5 parts and tricalcium phosphate 95 parts. Kephrine Hydrochloride Rectal Suppositories: Kephrine hydrochloride 3 parts, extract of belladonna 1 part, in 96 parts of a suppository base. Kephrine Hydrochloride Bandage: Bandages, 5 meters long and 1, 3, 5 and 8 centimeters wide, impregnated with kephrine hydrochloride, 1 Gm! per 3,000 square centimeters. 274 NEW AND NONOFFICIAL REMEDIES Kephrine Hydrochloride Gauze: Gauze impregnated with kephrine hydrochloride, 1 Gm. per 3,000 square centimeters. Kephrine hydrochloride occurs as a white, odorless powder; freely soluble in water, soluble in alcohol; insoluble in ether. Its aqueous solution is neutral to litmus. Kephrine hydrochloride "melts" with decomposition at 238 to ?40 C. Dissolve about 0.5 Gm. of kephrine hydrochloride in 25 cc. of water, add a very slight excess of ammonia water; collect the resultant methylaminoacetocatechol on a filter paper, wash and dry at 100 C.: a yellow crystalline powder results which on heating deepens in color at 200 C. and "melts" with decomposition at 230 C; the filtrate from the foregoing gives a white precipitate with silver nitrate solution, insoluble in boiling nitric acid but soluble in an excess of ammonia water. Dissolve about 0.02 Gm. of kephrine hydrochloride in 20 cc. of water; separate portions of 2 cc. yield a canary-yellow color with 1 cc. of ammonium molybdate solution, which is not discharged on subse- quent addition of 0.3 cc. of dekanormal sodium hydroxide solution (distinction from epinephrine) ; a bluish purple color with 0.2 cc. of a 1: 100 sodium nitroprusside solution, 1 cc. of sodium hydroxide solu- tion and 0.2 cc. of glacial acetic acid (.distinction from salts of ephedrine, neosynephrine and tyramine). Boil about 0.01 Gm. of kephrine hydrochloride with 2 cc. of alcoholic potassium hydroxide solution and 3 drops of chloroform: no odor of phenylisocyanide is evolved (primary amines). To about 0.1 Gm. of kephrine hydro- chloride in 5 cc. of water, add 1 cc. diluted hydrochloric acid and 1 cc. of barium chloride solution: no turbidity develops (sulfate). Dry about 0.5 Gm. of kephrine hydrochloride, accurately weighed, to constant weight at 100 C. : the loss does not exceed 7 per cent. Incinerate about 0.5 Gm. of kephrine hydrochloride, accurately weighed: the residue is not more than 0.1 per cent. Transfer about 0.25 Gm. of kephrine hydrochloride, accurately weighed, to a 500 cc. Kjeldahl flask and determine the nitrogen content according to the method described in Methods of Analysis of the Association of Official Agricultural Chemists, third edition, page 20, art. 22: the amount of nitrogen is not less than 6.35 per cent nor more than 6.5 per cent when calculated to the dried substance. Transfer about 0.3 Gm. of kephrine hydrochloride, accurately weighed, to a suitable Erlenmeyer flask, add 100 cc. of water, previously boiled to remove carbon dioxide and titrate with tenth-normal sodium hydroxide solu- tion using phenolphthalein as an indicator: the amount of hydrogen chloride found corresponds to not less than 16.5 per cent nor more than 17 per cent, calculated to the dried substance. Transfer about 0.3 Gm. of kephrine hydrochloride, accurately weighed, to a suitable glass stoppered Erlenmeyer flask, dissolve in about 20 cc. of water, neutralize with a diluted ammonium hydroxide _ solution, _ adding a very slight excess; place the flask and contents in a refrigerator at 5 C. and allow to stand for eighteen hours. Collect the precipitate on a tared Gooch crucible, wash with cold water followed by cold alcohol and ether, and dry to constant weight at 100 C: the percentage of methylaminoacetocatechol obtained corresponds to not less than 83 per cent, nor more than 86 per cent, calculated to the dried substance. LACTIC ACID-PRODUCING ORGANISMS AND PREPARATIONS Sour milk and lactic acid-producing bacteria are used for the treatment of vomiting, acute diarrhea, constipation, various chronic disorders of the gastro-intestinal tract and for the relief of general symptoms associated with these intestinal disorders both in children and in adults. It is difficult to evaluate the benefit derived from sour-milk or this form of bacterial therapy. LACTIC ACID-PRODUCING PREPARATIONS 275 Clinical opinion appears to indicate that some of the preparations are distinctly useful in certain cases. The preparations which have been used are: (1) Milk soured by the addition of lactic acid and (2) milk soured by the fermentation of lactose by a variety of microorganisms. Chemi- cally prepared lactic acid milk is not included in N. N. R. The milk preparations made by the fermentative activity of Strepto- coccus lacticus and Kefir fungi have been omitted because of their indefinite qualities and because they are not extensively prescribed. Bacillus hulgaricus preparations have been omitted because they contained an organism foreign to the intestinal tract of man and incapable of being implanted in the human intestine. The Bacillus acidophilus preparations have been retained because this organism is capable of implantation, growth and lactic acid-production in the intestine of man. Two classes of Bacillus acidophilus preparations are manu- factured commercially. One is a preparation of the growth of the organism in milk. The other is a group of broth cultures, and concentrates containing the organisms in various solutions or candy-like materials. Of these, the milk preparations appear to be preferable, although a positive opinion on this point must be withheld until questions are settled by further investigations. The benefit derived from milk soured by B. acidophilus may be attributed to (1) the nutritive value of the milk, (2) the ingested lactose, (3) the effect of lactic acid and (4) a special consequence of the predominance of the lactic acid-producing B. acidophilus in the intestine. No one denies the value of milk, whether sweet or sour, as a growth promoting and energy yielding food. The ingested lactose serves as nutriment for both man and the fermentative bacteria in the intestine. In fact, the feeding of at least 100 grams daily of lactose or dextrin is an essential part of the regimen, especially when cultures and concentrates of B. acidophilus are administered. The lactic acid appears to aid in the establishment of a condition favorable for the growth of aciduric bacteria in the intestine. When the lactic acid-producing bacteria, particularly B. acidophilus, become predominant in the intestine, either through the inges- tion of large numbers of them, by implantation or by the cre- ation of a condition favorable to the overgrowth of B. acidophilus when normally present, the putrefactive flora is reduced or suppressed. This result appears to be attributable largely to the continued production of lactic acid in the intestine and possibly to a less clearly understood process of bacterial antagonism. The evidence indicates that a predominantly putrefactive flora in the intestine is sometimes associated with malaise, headache, pains, nervousness, vomiting and other symptoms. The indeterminate names "auto-intoxication" and "intestinal toxemia" have been applied to these conditions. The Council, unable to find suitable definitions of these terms has attempted 276 NEW AND NONOFFICIAL REMEDIES to discourage their use. The replacement of putrefactive bac- teria by fermentative organisms which produce lactic acid with- out gas in the intestine has apparently been followed by relief of these symptoms. But there has been gross overstatement of the benefits derivable from therapy with lactic acid-producing bacteria. The Council is opposed to the exploitation of the products as remedies for such indefinite conditions as "auto- intoxication" and "intestinal toxemia" and as direct contributors to the longevity, psychic sanity and general well-being of indi- viduals. The lactic acid-bacteria may promote health, but are not regarded as essential or specific vehicles of something necessary for health. The conditions essential to the transformation of the intestinal flora, allowing the fermentative lactic acid type to predominate, are the feeding of lactose in quantities in excess of 100 Gm. daily, or the administration of large amounts of viable cultures of B. acidophilus together with liberal quantities of lactose or dextrine. Thus far, the most successful method of producing this transformation of the intestinal flora has been the use of milk fermented by B. acidophilus, containing at the time of ingestion a large number of viable organisms. Bacillus acidophilus milk is prepared by the inoculation of sterilized milk with a "starter" made by growing B. acidophilus at 35 to 2)7 C. for from 24 to 48 hours in sterilized milk. ( Jn the comr)letion of proper "ripenhiGT." which should occur within from 24 to 48 hours at 35 to Z^ C, a product is obtained which is slightly sour to the taste and has a characteristic odor resembling that of ordinary buttermilk. There is a slight separation of whey, but on thorough mixing the product has a uniform creamy consistency. The most favorable practical storage temperature for the usual tvpe of this product is 12 to 16 C. Bacillus acidophilus milk, broth cultures and concentrates will be considered acceptable provided the number of viable organisms contained in a stated quantity at the time of manu- facture is declared on the label, provided that the label bears an expiration date and provided that for both cultures and for concentrates the advertising emphasizes the need of coin- cident administration of carbohydrates (lactose or dextrin). The time of manufacture is defined as the date when the pro- ducer completes the preparation of the product for sale. At this date the preparation should contain not less than 200 million viable B. acidophilus per cubic centimeter of milk or broth or per gram of concentrate. The expiration date is defined as the Gate after the time of manufacture on which the prepara- tion will contain not less than 100 million viable B. acidophilus per cubic centimeter of milk or broth or per gram of concen- trate. This period will vary under different conditions of acidity of the preparation or different storage temperatures and as a result of other factors. For properly made and stored preparations of B. acidophilus milk, the expiration date will LACTIC ACID-PRODUCING PREPARATIONS 277 usually be one week, and probably less than two weeks, after the date of manufacture. Liquid cultures and aqueous suspensions of the lactic acid- producing organisms have been used as local appHcations in attempts to check infections of mucous membranes, and to arrest putrefaction or suppuration in wounds, abscesses and sinuses. There is no convincing evidence in favor of such use, and the Council will not accept preparations recommended for these purposes. Bacillus acidophilus (also called Lactobacillus acidophilus) belongs to the aciduric lactobacillus group which is widely distributed in nature. This group of bacteria contains many varieties of related organisms. Bacillus acidophilus and Bacillus bifidus are found in the gastro-intestinal tract of man and animals. Bacillus bulgaricus usually occurs in the intestinal contents of cattle. It is frequently present in dairy products, contaminated with fecal material from cows. The morphology of these bacteria are somewhat variable. They are usually long and fairly slender bacilli, which at times form filaments. Branched forms, common _ in B. bifidus is rarely seen in the other members of this group. Typical forms in young cultures are Gram-positive. They are preferably micro- aerophilic. Some strains require added CO2 for normal growth. Growth of these organisms is greatly aided by the presence of various carbohydrates in the medium. Milk is a particularly good medium for the preservation of viability. B. acidophilus ferments dextrose and lactose regularly. Most strains ferment maltose, sucrose and raffinose. Mannitol is rarely fermented. Approximately one-half of the strains ferment salicin. Of the total acid produced in the fermentation of lactose 12 to 20 per cent is optically inactive lactic acid. For isolation purposes and for the study of colonies, whey agar, casein digest agar or tomato juice agar are used. The cultures of B. acidophilus producing "rough" colonies are regarded as being most suitable for intestinal implantation. CHEPLIN'S B. ACIDOPHILUS MILK.— A milk cul- ture of B. acidophilus. It contains not less than 250 millions viable organisms (B. acidophilus) per cubic centimeter at the time of sale. Actions and Uses. — See preceding article, Lactic Acid- Producing Organisms and Preparations. Dosage. — For adults, from 500 to 1,000 cc, increased or decreased to meet individual requirements. When employed in infant feeding, it may be diluted with water which has been boiled and cooled, or with solution of calcium hydroxide in such proportions as the case may demand but it should be borne in mind that this product does not possess the full growth pro- moting potency of whole milk; lactose (sugar of milk) should be added to restore the normal sugar content. Cheplin's B. acidophilus milk is marketed in bottles containing 400 cc. It must be kept on ice and should be consumed within the period of time stamped on the package (three weeks from date of preparation). Manufactured by Cheplin Biological Laboratories, Inc., Syracuse, N. Y. No U. S. patent or trademark. Fresh skimmed cow's milk, standardized with 40 per cent cream so that its final fat content is not less than one-half of 1 per cent, is sterilized in one heating at 120 C. for 15 minutes. After cooling to 278 NEW AND NONOFFICIAL REMEDIES at least Zl C., the milk is inoculated with a twenty-four-hour culture of pure strains of B. acidophilus which have been grown, by repeated transfers, sufficiently long in milk to develop rapidly and bring about proper coagulation of the casein. Viable milk cultures of the organ- isms are employed as the inoculum. After inoculation the milk is kept at Z7 C. for from 20 to 24 hours until an acidity is reached such that 10 CO. will require for neutralization 10 cc. of tenth-normal sodium hydroxide solution, using phenolphthalein as indicator. The product is then agitated until completely homogenous, transferred to 400 cc. bottles, which are closed with seals and cooled to 5 C. The strains of B. acidoph- ilus used are isolated by Cheplin. To insure maximum therapeutic effects and colonization within the human alimentary canal, the organism is freshly isolated from human intestinal contents as frequently as is found necessary through actual feeding experiments. SHEFFIELD B. ACIDOPHILUS MILK.— A whole milk cultured with Bacillus acidophilus. It contains not less than 250 million viable organisms per cubic centimeter at the time of sale. Actions and Uses. — See general article, Lactic Acid-Producing Organisms and Preparations. Dosage. — For adults 1,000 cc. per day, increased or decreased to meet individual requirements. When employed in infant feeding, it may be diluted with boiled water. Sheffield B. acidophilus milk must be kept in a cool place and should be used prior to the expiration date stamped on the label. Manufactured by the Cheplin Biological Laboratories, Inc., Syracuse, N. Y. (Sheffield Farms Co., Inc., New York, N. Y., distributor). No U. S. patent or trademark. Fresh whole cow's milk with a butter fat content of not less than 3 per cent is sterilized at 100 C. for two hours. After cooling at 37 C, the milk is inoculated with a twenty hour seed culture of pure strains of Bacillus acidophilus. After inoculation the milk is kept at 37 C. for from twenty to twenty-four hours until an acidity is reached such that 10 cc. _ will require for neutralization 8 cc. of tenth-normal sodium hydroxide solution, phenolphthalein being used as indicator. The product is then cooled, agitated until homogeneous and transferred to one-half pint, pint and quart bottles. The strains of Bacillus acidophilus used are isolated by Cheplin. To insure a high degree of activity and colonization within the human alimentary tract, the organism is freshly isolated from human intestinal contents as frequently as is found necessary through actual feeding experiments. SUPPLEE B. ACIDOPHILUS MILK.— A whole milk cultured with Bacillus acidophilus. It contains not less than 200 million viable B. acidophilus organisms at the date of manu- facture and not less than 100 million at the expiration date. Actions and Uses. — See general article. Lactic Acid-Produc- ing Organisms and Preparations. Dosage. — For adults 1,000 cc. per day, increased or decreased to meet individual requirements. When employed in infant feeding, it may be diluted with boiled water. Supplee B. acid- ophilus milk must be kept in a cool place and should be used prior to the expiration date stamped on the label. Manufactured by the Cheplin Biological Laboratories, Inc., Syracuse, N. Y. (Supplee- Wills-Jones Milk Co., Philadelphia, Pa., distributor). No U. S. patent or trademark. Fresh whole cow's milk with a butter fat content of not less than 3 per cent is sterilized at 100 C. for two hours. After cooling to 37 C. the milk is inoculated with a twenty hour seed culture of pure strains LIQUID PETROLATUM 279 of Bacillus acidophilus. After inoculation the milk is kept at 37 C. for from twenty to twenty-four hours until an acidity is reached such that 10 cc. will require for neutralization 8 cc. of tenth-normal sodium hydroxide solution, phenolphthalein being used as indicator. The product is then cooled, agitated until homogeneous and transferred to one-half pint, pint and quart bottles. The strains of Bacillus acidoph- ilus used are isolated by Cheplin. To insure a high degree of activity and colonization within the human alimentary tract, the organism is freshly isolated from human intestinal contents as fre- quently as is found necessary through actual feeding experiments. LANOLIN. — A name applied to Hydrous Wool Fat- U. S. P., which contains not less than 25 per cent and not more than 30 per cent of water. For standards see the U. S. Phar- macopeia under Adeps Lanae Hydrosus. LENIGALLOL, — Pyrogallolis Triacetas. — Triacetyl pyrogallol. C6H3(CH3C02)3. — Pyrogallol triacetate, obtained by replacing the hydroxyl groups of pyrogallol with acetate groups. Actions and Uses. — Lenigallol as such is said to be nonpoison- ous and nonirritating, but it produces a mild and painless cor- rosive effect by the gradual liberation of pyrogallol. (See note under Creosote and Guaiacol Compounds.) It is introduced as a substitute for pyrogallol in psoriasis, lupus, acute and subacute eczema of children and other skin diseases. Dosage. — In 5 to 10 per cent ointment, usually with zinc oxide. Manufactured by Knoll A.-G., Ludwigshafen a.Rh., Germany (Bilhuber- Knoll Corporation, Jersey City, N. J., distributor). No U. S. patent or trademark. Lenigallol-Zinc Ointment. It contains lenigallol 6 per cent in a base composed of zinc oxide ointment-U. S. P. Lenigallol is prepared by boiling 10 parts of pyrogallol, 1 part sodium acetate and 25 parts of acetic anhydride for two hours, and washing the crystalline product on a filter with water. It is a white, crystalline powder, melting at 165 C. It is insoluble in water, but soluble with decomposition in warm aqueous alkalis. Lenigallol is incompatible with alkalis, strong acids and oxidizing agents. LIQUID PETROLATUM.— Liquid Paraffin.— White Mineral OiL — "A mixture of liquid hydrocarbons obtained from petrolatum." U. S. P. For standards see the U. S. Pharmacopeia under Petrolatum Liquidum. Actions, Uses and Dosage. — See Useful Drugs. Maltine with Mineral Oil and Cascara Sagrada: An emulsified mixture of liquid petrolatum, 40 cc, and maltine, 60 cc, containing a non-bitter extract of cascara sagrada representing 2.2 Gm. of cascara sagrada per 100 cc. Maltine meets the requirements given for this product under Maltine with Cod Liver Oil (which see under Vitamin Preparations). 280 NEW AND NONOFFICIAL REMEDIES Prepared by The Maltine Co., Brooklyn. No U. S. patent. U. S. trademark 44,566. Petrolagar: Liquid petrolatum 65 cc, emulsified witli agar in a men- struum containing sugar, flavoring, sodium benzoate 0.1 Gm., and water to make 100 cc. Prepared by the Petrolagar Laboratories, Inc., Chicago. No U. S. patent. U. S. trademark 165,616. Petrolagar (Unsweetened) : Liquid petrolatum 65 cc, emulsified with agar in a menstruum containing sodium benzoate 0.1 Gm., and water to make 100 cc. Prepared by the Petrolagar Laboratories, Inc., Chicago. No U. S. patent. U. S. trademark 165,616. Petrolagar with Cascara (Non-Bitter) : _ Liquid petrolatum 65 cc, emulsified with agar in a menstruum containing non-bitter fluid extract of cascara sagrada 13.2 cc, sugar, flavoring, sodium benzoate 0.1 Gm., and water to make 100 cc. Prepared by the Petrolagar Laboratories, Inc., Chicago. No U. S. patent. U. S. trademark 165,616. Petrolagar (with Milk of Magnesia) : Liquid petrolatum, 65 cc, mag- nesia magma, 8 cc; emulsified with agar in a menstruum containing sugar, flavoring, sodium benzoate 0.1 Gm., and water to make 100 cc. Prepared by the Petrolagar Laboratories, Inc., Chicago. No U. S. patent. U. S. trademark 165,616. Petrolagar (with Phenolphthalcin) : Liquid petrolatum 65 cc, emulsified with agar in a menstruum containing phenolphthalcin 0.32 Gm., sugar, flavoring, sodium benzoate 0.1 Gm., and water to make 100 cc. Prepared by the Petrolagar Laboratories, Inc., Chicago. No U. S. patent. U. S. trademark 165,616. Squibb' s Mineral Oil with Agar: Liquid petrolatum-Squibb, heavy (California), 50 cc. ; agar, 1.5 Gm. ; sodium benzoate 0.1 Gm.; acacia, glycerin, water and flavoring sufficient to make 100 cc. Prepared bv E. R. Squibb & Sons, New York. U. S. patent 1,799,804 (April 7, 1931; expires 1948) and 1,913,561 (June 13, 1933; expires 1950). No trademark. Squibb' s Mineral Oil with Agar and Phcnolphthalein: Liquid petro- latum-Squibb, heavy (California), 50_cc.; agar, 1.5 Gm.; phenolphthalcin, 3.1 Gm. {\y2 grains per fluidounce)'; sodium benzoate, 0.1 Gm.; acacia, glycerin, water and flavoring sufficient to make 100 cc. Prepared bv E. R. Squibb & Sons, New York. U. S. patent 1,799,804 (April 7, 1931: expires 1948) and 1,913,561 (June 13, 1933; expires 1950). No trademark. Liquid Petrolatum-Merck. — A brand of liquid petrolatum- U. S. P. Manufactured by Merck & Co., Railway, N. J. Smith's Mineral Oil. — A brand of liquid petroleum-U. S. P. ^Manufactured by Smith Oil & Refining Co., Rockford, Illinois. Liquid Petrolatum Heavy (California) -Squibb. — A brand of liquid petrolatum-U. S. P. Manufactured by E. R. Squibb & Sons, New York. MAGNESIUM COMPOUNDS PLANT'S MAGNESIA WAFERS.— Wafers, each con- taining magnesium hydroxide, Mg(0H)2, 0.3 Gm. (4.64 grains) compressed with the addition of sucrose and starch and essential oils as flavors. MAGNESIUM COMPOUNDS 281 Actions and Uses. — Plant's magnesia wafers are used as an alkaline laxative and antacid. Dosage. — From two to four wafers, followed by a glassful of water. The magnesium content of each wafer is approximately equivalent to that of 4 cc. of magnesia magma-U. S. P. Manufactured by the Arner Company, Buffalo (The Plant Products Company, Cleveland, Ohio, distributor). U. S. Patent 1,694,341 (Dec. 4, 1928; expires 1945). U. S. trademark 239,341. TRIBASIC MAGNESIUM PHOSPHATE. — Mag- nesii Phosphas Tribasicus. — Tertiary ^Magnesium Phos- phate, AIg3(P04)2.7H20. Tribasic magnesium phosphate con- tains approximately 70 per cent AlgaCPOi)^. Actions and Uses. — Tribasic magnesium phosphate has been proposed for use as an antacid. It has the advantage over alkaline hydroxides such as magnesium hydroxide and alkali carbonates such as sodium bicarbonate in that, being insoluble, it neutralizes the excess of acid in the stomach, but does not produce systemic alkalization. It has been claimed that tribasic magnesium phosphate has a laxative action. Dosage. — From 1 to 5 Gm. (15 to 75 grains). Tribasic magnesium phosphate occurs as a white, odorless and taste- less powder. It is almost insoluble in water, but it is readily soluble in diluted mineral acids. Water agitated with tribasic magnesium phos- phate is neutral or acquires a slightly alkaline reaction to litmus paper. Dissolve about 0.2 Gm. of tribasic magnesium phosphate in a slight excess of diluted nitric acid and add ammonium molybdate solution: yellow precipitate forms which is soluble in am.monia water. Mix 0.2 Gm. of tribasic magnesium phosphate with about 5 cc. of water, then add 20 cc. of neutral solution of silver nitrate (1 in 20) and agitate the mixture for about two minutes, keeping protected from light: the liquid is neutral to litmus paper (distinction from dibasic phosphate), and the precipitate is of a pure yellow color, free from brown or gray (uncombined magnesium oxide). A solution of 0.2 Gm. of the salt in 10 cc. of water and just sufficient hydrochloric acid is not darkened by the addition of an equal volume of hydrogen sulfide water (heavy metals). Mix 0.5 Gm. of the salt with 3 cc. of water and add 3 cc. of diluted hydrothloric acid: not more than a few gas bubbles should be evolved (carbonate). Add 5 cc. of sodium hydroxide solution to 0.5 Gm. of tribasic magnesium phosphate solution and heat: the odor of ammonia is not evolved (magnesium ammonium phosphate). To a solution of 0.5 Gm. of the salt in 10 cc. of diluted hydrochloric acid, filtered if necessary, add a few drops of diluted sulfuric acid: no turbidity is produced in ten minutes (barium). Dissolve 0.2 Gm. of tribasic magnesium phosphate in 5 cc. of diluted nitric acid, add a few cubic centimeters of sulfuric acid and heat until fumes of sulfur trioxide are evolved; add 10 cc. of sulfurous acid solution, and evaporate until the solution is free from sulfur dioxide; dilute the evaporated solution to 5 cc. : this meets the U. S. P. X limits for arsenic. Add 30 cc. of water to 1 Gm. of the salt; follow with 5 cc. of hydrochloric acid, warm if necessary until the salt is dissolved, cool, add ammonia water in small proportions until a permanent precipitate is just produced and then add 5 cc. acetic acid: not more than a slight quantity remains undissolved (aluminum, iron, etc.). Filter the solu- tion, if not clear add 5 cc. ammonium oxalate: not more than a slight turbidity is produced (calcium). Dilute 1 cc. of the solution to 200 cc. and add ammonia water until alkaline to litmus paper: a white crystal- line precipitate gradually appears. When tribasic magnesium phosphate 282 NEW AND NONOFFICIAL REMEDIES is assayed for chloride and sulfate according to the method described in the U. S. P. X, page 462, their sum should not exceed 0.5 per cent. Digest 2 Gm. of the salt with 100 cc. of water for one-half hour on a steam bath, cool, add sufficient water to restore the original volume, mix and filter; evaporate 50 cc. of the filtrate to dryness and ignite gently: the weight of the residue does not exceed 0.015 Gm. (soluble salts). Agitate 1 Gm. of tribasic magnesium phosphate with 20 cc. of water for five minutes, filter, and add to the filtrate 2 drops phenol- phthalein solution: the pink color, if any, is completely discharged by one drop of tenth-normal acid {uncomhined magnesium oxide). Determine the phosphate content of tribasic magnesium phosphate by the method given under tribasic calcium phosphate. The amount of phosphate (PO4— ) should not be less than 50 per cent. Dissolve about 0.5 Gm. of tribasic magnesium phosphate, accurately weighed in 25 cc. of diluted hydrochloric acid; add ammonia water in small portions until a permanent precipitate is just produced and redissolve the precipitate by the addition of acetic acid; if the solution is not clear, filter and wash; add to the solution 10 cc. of sodium phos- phate T. S., then render strongly alkaline by the addition of stronger ammonia water; allow the mixture to stand twenty-four hours; filter on a tared Gooch crucible and wash the precipitate with diluted ammonia water (1 volume of ammonia water diluted with 19 volumes of water) until the washings cease to give a reaction for chloride, ignite and weigh: the percentage of magnesium found multiplied by 2.605 (factor Mg to P04= in Mg3(P04)2) should correspond to the percentage of phosphate (P04=) found plus or minus 1.5 per cent. On ignition it loses from 25 per cent to 30 per cent of its weight. Magnesium Phosphate Tribasic-Merck. — A brand of tribasic magnesium phosphate-N. N. R. Manufactured by Merck & Co., Inc., Rahway, N. J. No U. S. patent or trademark. MENTHOL. — "An alcohol obtained from oil of peppermint or other mint oils or prepared synthetically." U. S. P. For standards see the U. S. Pharmacopeia under Menthol. Pemco Menthol Eucalyptus Compound Nasal Spray: Menthol, ^ per cent; oil of eucalyptus, 8 per cent; creosote, 1:1,400; epinephrine hydro- chloride, 1:100,000; olive oil, ^ per cent; oil of Cassia, J/2 per cent; liquid petrolatum, 90 J4 per cent. Prepared by the Prophylacto Manufacturing Co., Chicago. MERCURY AND MERCURY COMPOUNDS Mercury has been employed in the treatment of disease since time immemorable. It was employed very early in the treat- ment of skin diseases, metallic mercury being used incorporated in various ointments with elaborate bases. Naturally, when syphilis was called to the attention of the early practitioners, it was to be expected that they would employ some of these mercurial ointments for treating the disease. Thus mercury inunctions were the first form of mercury employed in treating syphilis. Later, MathioH used it internally in the form of red mercuric oxide. Still others tried pills of metallic mercury internally, and mercury salts in solutions were also extensively used, for example, van Swieten's sublimate solution. In the MERCURY COMPOUNDS 283 early part of the nineteenth century the yellow mercurous iodide tablet was suggested and used by Ricord and later by his cele- brated pupil, Fournier. Jonathan Hutchinson introduced mer- cury with chalk in the latter half of the last century. This also had a great vogue over a period of time. Mercury fumigations were employed quite extensively in the sixteenth to eighteenth centuries, but were discarded because of their danger. The intramuscular and intravenous injections of mercury salts have been used only in the past fifty or sixty years. One now finds the oral method of administration to be rarely employed. It is often the cause of troublesome gastro-intestinal symptoms, the inunction method obviates the digestive disturbances. If this method is to be employed, it is necessary for the physician to instruct the patient to rub in the ointment vigorously for thirty minutes by the clock. Only the mercury that penetrates the hair follicles is absorbed. Simply placing the ointment on the outside of the skin is of little value. After rubbing it in for thirty minutes, it probably is permissible to remove the excess that is left on the skin by the use of soap and water, or even a small amount of benzin with a cloth. In using mercury inunctions, different sites should, if possible, be employed each night for at least six nights. As a rule, hairy persons do not stand inunctions well ; there is a tendency to the development of folliculitis. In more recent years the attempt to improve mercurial therapy has been mainly along two lines : the perfection of intramuscular usage and the introduction of the organic compounds. The intramuscular injections are of two types, either of the soluble or of the insoluble salts. As a rule the soluble salts are somewhat more painful and because of their rapid absorption require an injection daily, or at least every other day. They are of great value in getting the patient under rapid mercurial- ization. For this same purpose one may also employ intra- venous injections, though they are not used much in this country. Moreover, these preparations when given intra- venously must be given daily if they are to do any good, since mercury is so rapidly immobilized, and as a rule daily intra- venous injections are scarcely practical. The most popular of the soluble salts are probably mercury bichloride, red mercuric iodide and mercuric succinimide. Mercuric cyanide and mer- curic oxycyanide are used considerably in France for intravenous administration. The claim is made for the insoluble salts of mercury that they do not require administration so frequently and that they are less painful. True, there is danger of a certain amount of cumulative absorption so that it is necessary for the physician to watch the patient very closely when the insoluble salts are being employed. The difference between the mercurous and mercuric compounds is primarily one of solubility and absorp- tion. After the mercurous compounds are absorbed, a process that is quite possibly preceded by their oxidation to mercuric 284 NEW AND NONOFFICIAL REMEDIES compounds, no difference has been demonstrated. Of the insol- uble, or perhaps better, semisoluble, salts, mercuric salicylate is probably the best and should be comparatively safe if the patient is observed carefully, the injections required being given only once a week. In using mercury in the treatment of syphilis the physician should watch the patient carefully for symptoms of intoxica- tion; for example, stomatitis, gastro-intestinal symptoms, or symptoms of irritation of the kidneys. Several organic compounds of mercury have also been intro- duced. Originally these were suggested in the treatment of syphilis. They probably, however, have a very limited anti- syphilitic efficiency. Several of these organic compounds are being used as diuretics with notable success, for example, merbaphen and mersalyl. Compounds of mercury are also used for the preparation of antiseptic and germicidal solutions. In recent years solutions of compounds of mercury with dyes or other organic radicals have been used extensively in place of mercuric chloride, mercuric cyanide and mercuric iodide for disinfection of the skin, for the treatment of infected wounds and for the treatment of systemic bacterial infections. In general these organic compounds of mercury are claimed to be less toxic and less irritating than the older chlorides, iodides and cyanides of mercury. They possess definite capacity to disinfect superficial layers of tissue. Claims for their ability to penetrate deeply into living tissue and to act as efficient chemotherapeutic agents after injection into the blood stream have not been established. MERCURY.— Quicksilver.— "Contains not less than 99.5 per cent of Hg." U. S. P. For standards see the U. S. Pharmacopeia under Hydrar- gyrum. Mercuric Compounds MERCURIC BENZOATE. — Hydrargyri Benzoas.— Hydrargyrum Benzoicum. — Hg(C6H5COO)2+H20. — The mer- curic salt of benzoic acid. Actions and Uses. — The same as those of mercuric chloride. Dosage. — Mercuric benzoate is used for intramuscular injec- tions in syphilis and locally in the treatment of gonorrhea. For intramuscular injection, mercuric benzoate is given in a 1 per cent solution by dissolving 0.3 Gm. of mercuric ben- zoate in 30 cc. of water, containing 1.5 Gm. of ammonium benzoate or given in 2 per cent solution with 2.5 per cent of sodium chloride, the average dose being about 12 or 24 minims, respectively (0.015 Gm., ^ grain, or 0.03 Gm., ^ grain), every second day. For urethral irrigation the solution may be 1 in 2,000 or 1 in 1,000 with an equal quantity of sodium chloride. Mercuric benzoate is a white, crystalline powder; slightly soluble in water, yielding a weakly acid solution ; more soluble in an aqueous sodium chloride solution. It is insoluble in alcohol or ether. At 20 C, MERCURY COMPOUNDS 285 a 10 per cent solution of sodium benzoate dissolves 1 per cent of its weight of mercuric benzoate. With alcohol mercuric benzoate is decom- posed into a basic salt having a yellow color. A solution of 1 Gm. of mercuric benzoate and 0.5 Gm. of sodium chloride in 20 cc. of water yields a black precipitate with hydrogen sulfide, and with ferric chloride solution, it yields a fawn-colored precipitate of ferric benzoate. Shake 1 Gm. of mercuric benzoate with 20 cc. of water and filter: no turbidity is produced when silver nitrate solution is added to 10 cc. of the filtrate acidified with a few drops of nitric acid (chloride). Two cc. of a similar solution, when mixed with ferrous sulfate solution to which is added sulfuric acid so as to form a layer beneath, should produce no brown coloration at the zone of contact of the two solutions initrates). Incinerate aboiit 0.5 Gm. of the salt in a porcelain crucible: not more than 0.1 per cent of residue remains. MERCURIC CYANIDE. — Hydrargyri Cyanidum.— Hydrargyrum Cyanatum. — Hg(CN)-. — The mercuric salt of hydrocyanic acid. Actions and Uses. — Mercuric cyanide has been reported to be as actively antiseptic as mercuric chloride and to be less irritating ; but this has been questioned. It is used locally and internally as is mercuric chloride. Blum and Schwab (Presse Med. 30:1081 [Dec. 16] 1922) highly recommended this drug as a diuretic in cardiac (but not in renal) disease. They give it in doses of 0.04 to 0.05 Gm. by intravenous or intramuscular injection. They state, however, that mercury should be used as a diuretic only as a last resort when other drugs have failed. Do.yo^^.— Internally, from 0.004 to 0.008 Gm. (i/ie to ^ grain) ; locally, solutions of from 1 in 4,000 to 1 in 2,000 may be used for applications to the eye or mucous membranes ; from 25 to 35 minims of a 1 per cent solution may be used hypoder- mically without causing local irritation. Death has occurred from the use of a vaginal injection containing 0.9 Gm. (14 grains) of mercuric cyanide. In diphtheria and croup, it is used in 0.01 per cent solution as a gargle or internally in doses of from 0.0005 Gm. to 0.001 Gm. In fibrinous rhinitis it is used on a tampon in 0.04 per cent solution. Mercuric cyanide occurs in colorless or white, prismatic crystals, or white powder, odorless and having a bitter, metallic taste (the salt is exceedingly poisonous). It is darkened on exposure to light; is soluble at 15 C. in 12.8 parts of water and in 15 parts of alcohol, in 3 parts of boiling water and in 6 parts of boiling alcohol, and is very sparingly soluble in ether. When slowly heated in a glass tube, the salt decrepitates and decom- poses into metallic mercury and inflammable cyanogen gas, which burns with a purple flame. On further heating, the blackish residue con- sisting of paracyanogen with globules of metallic mercury, is wholly dissipated. If 1 part of the salt is gently heated with 1 part of iodine in a dry test-tube it will produce at first a yellow sublimate, which afterward becomes red, and above this a sublimate of colorless, needle- shaped crystals. On adding hydrochloric acid to the aqueous solution of the salt, the odor of hydrocyanic acid is evolved. A 5 per cent aqueous solution of the salt should be neutral to litmus paper, and 286 NEW AND NONOFFICIAL REMEDIES should not yield, on tbe gradual addition of a few drops of potassium iodide solution, either a red or a reddish precipitate, soluble in an excess of the precipitant, nor should it yield a white precipitate with silver nitrate solution (mercuric chloride). If mercuric cyanide is dissolved in an aqueous solution of sodium chloride, the addition of phenolphthalein to this solution should produce no red coloration (mercuric oxide). Ammonia should not color an aqueous solution blue (mercuric oxide). Ammonia water dissolves mercuric cyanide without producing a white precipitate (oxy cyanide). Mercuric Cyanide-Mallinckrodt. — A brand of mercuric cyanide-N. N. R. Manufactured by the Mallinckrodt Chemical Works, St. Louis. No U. S. patent or trademark. Mercury Cyanide-Merck. — A brand of mercuric cyanide- N. N. R. Merck & Co., Inc., Rahway, N. J., distributor. No U. S. patent or trademark. MERCURIC OXYCYANIDE. — Hydrargyri Oxy- cyanidum. — Hydrargyrum Oxycyanatum. — Hg(CN)2HgO. — A basic-mercuric salt of hydrocyanic acid, containing from 51.7 to 56.0 per cent of mercuric cyanide [Hg(CN)2] and from 44.3 to 48.0 per cent of mercuric oxide (HgO). Actions and Uses. — Mercuric oxycyanide has been proposed as a substitute for mercuric chloride. Its antiseptic power is claimed to be greater and it is asserted to be less irritating than mercuric chloride because it does not act on albumin to the same extent. It has advantage over mercuric chloride in that it does not corrode steel instruments. Representative syphilographers differ as to the use of mer- curic oxycyanide intravenously. Some believe that its use should be limited to hospitals ; others, that it has no advantage over other and safer methods of administering mercury ; while others consider it safe and valuable; but all are in accord that its safe use requires experience. It is used quite extensively by the French in the treatment of syphilis, generally being employed by the intravenous route. Dosage. — Alercuric oxycyanide may be administered in the same doses as mercuric chloride. It may be applied locally in solutions of 1 in 5,000 or somewhat stronger. Sterile Ampules of Mercury Oxycyanide, 0.008 Gm.: Each contains 5 cc. of solution representing 0.008 Gm. (J^ grain) of mercuric oxy- cyanide-N. N. R. Prepared by the Abbott Laboratories, North Chicago, 111. Sterile Ampules Mercury Oxycyanide, 0.016 Gm.: Each contains 5 cc. of solution representing 0.016 Gm. (^ grain) of mercuric oxycyanide- N. N. R. Prepared by the Abbott Laboratories, North Chicago, 111. Sterile Ampules of Mercury Oxycyanide 0.01 Gm.: Each contains 5 cc. of solution, representing 0.01 Gm. (J^ grain) of mercuric oxycyanide- N. N. R. Prepared by the Abbott Laboratories, North Chicago, 111. MERCURY COMPOUNDS 287 Mercuric oxycyanide occurs as a white, or nearly white, micro- crystalline powder, soluble in about 80 parts of water, yielding a solu- tion alkaline to litmus. Boiled with a mixture of sodium hydroxide, ferrous sulfate and ferric chloride solutions, cooled and then treated with hydrochloric acid, mercuric oxycyanide yields a blue precipitate. A saturated solution yields a white precipitate with ammonium chloride, soluble in an excess of the precipitant. Tannic acid solution produces at first a deep yellow color, then gradually a tan colored precipitate. Hydrogen sulfide, and ammonium sulfide both produce a black pre- cipitate in an aqueous solution of mercuric oxycyanide. Potassium iodide solution when added to a solution of mercuric oxycyanide yields a red precipitate soluble in excess of the iodide. An aqueous solution should not respond to tests for chloride, nor should 0.2 Gm. leave a weighable residue when ignited. Dissolve about 0.5 Gm. of mercury oxycyanide, accurately weighed, in 50 cc. of warm water, together with 0.5 Gm. of sodium chloride, cool the solution, add methyl orange and titrate with tenth-normal hydrochloric acid to the red-end point. Add 2 Gm. of potassium iodide, dilute with water to about ISO cc. and titrate again with the tenth-normal acid to the red-end point: in the first titration, each cubic centimeter of tenth-normal hydrochloric acid solution is equiva- lent to 0.01083 Gm. of HgO and in the second, each cubic centimeter of tenth-normal hydrochloric acid solution is equivalent to 0.012631 Gm. of Hg(CN)2. MERCURIC SALICYLATE.— "A compound of mercury and salicylic acid containing not less than 54 per cent and not more than 59.5 per cent of Hg." U . S. P. For standards see the U. S. Pharmacopeia under Hydrargyri Salicylas. Afiipules Mercury Salicylate, 1 grain (0.065 Gm.) Suspended in Oil, 1 cc: Each 1 cc. ampule contains mercury salicylate, 1 grain (0.065 Gm.), quinine and urea hydrochloride, 0.05 Gm., anhydrous wool fat 0.1 Gm., distilled water 0.05 cc. and Wesson oil (maize oil) to make 1 cc. Prepared by the Cheplin Biological Laboratories, Inc., Syracuse, N. Y. Glaseptic Ampoules Mercury Salicylate-P. D. & Co., 0.065 Gm. (1 grain): Each cubic centimeter contains mercuric salicylate 0.065 Gm.; apothesine, 0.01 Gm.; in olive oil, 1 cc. Prepared by Parke, Davis & Co., Detroit. Glaseptic Ampoules Mercury Salicylate-P. D. & Co., 0.13 Gm. (2 grains): Each cubic centimeter contains mercuric salicylate, 0.13 Gm.; apothesine, 0.01 Gm.; in olive oil, 1 cc. Prepared by Parke, Davis & Co., Detroit. Sterile Ampoules Mercury Salicylate 0.065 Gm. (1 grain): Each ampule contains mercuric salicylate, 0.065 Gm.; camphor, 10 per cent; eugenol, 1 per cent; in neutral vegetable oil, 1 cc. Each ampule contains more than 1 cc. of suspension. Prepared by the Abbott Laboratories, North Chicago, 111. Sterile Ampules of Mercury Salicylate-H. IV. & D., 1 grain: One cc. of suspension contains 0.06 Gm. (1 grain) of mercuric salicylate Each ampule contains more than 1 cc. of suspension. Mercuric salicylate is suspended in a mixture of vegetable fats which are solid at 34.4 C, but liquid at body temperature. For use, the ampule is immersed in warm water until the fat is liquefied, agitated and opened, and a measured quantity of the contents injected through a 20-gage needle. This prepa- ration should not be injected intravenously. Prepared by Hynson, Westcott & Dunning, Baltimore. No U. S. patent or trademark. Sterile Ampules of Mercury Salicylate-H. IV. & D., lYz grains: One re. of suspension contains 0.09 Gm. (li^ grains) of mercuric salicylate. 288 NEW AND NONOFFICIAL REMEDIES Each ampule contains more than 1 cc. of suspension. Mercuric salicylate is suspended in a mixture of vegetable fats which are solid at 34.4 C., but liquid at bodj' temperature. For use, the ampule is immersed in warm water until the fat is liquefied, agitated and opened, and a measured quantity of the contents injected through a 20-gage needle. This prepa- ration should not be injected intravenously. Prepared by Hynson, Westcott & Dunning, Baltimore. No U. S. patent or trademark. Sterile Ampiiles of Mercury Salicylate-H. IV. & D., 2 grains: One cc. of suspension contains 0.12 Gm. (2 grains) of mercuric salicylate. Mercuric salicylate is suspended in a mixture of vegetable fats which are solid at 34.4 C., but liquid at body temperature. For use, the ampule is immersed in warm water until the fat is liquefied, agitated and opened, and a measured quantity of the contents injected through a 20-gage needle. This preparation should not be injected intravenously. Prepared by Hynson, Westcott & Dunning, Baltimore. No U. S. patent or trademark. MERCURIC SUCCINIMIDE.— "Contains, when dried for twenty-four hours over sulfuric acid, not less than 49.5 per cent and not more than 51 per cent of Hg, corresponding to not less than 98 per cent of (CH.oCO). : NHgN : (COCH,)^." U. S. P. For standards see the U. S. Pharmacopeia under Hydrargyri Succinimidum. Actio)is and Uses. — ^Mercuric succinimide has the action of other salts of mercury, but its solutions are said to be rela- tively nonirritating. The preparation is used as are other com- pounds of mercury in the treatment of syphilis. Dosage. — Mercuric succinimide is used mainly by hypoder- mic injection. The daily hypodermic dose is from 0.01 to 0.02 Gm. (Yq to Vs grain) given in the form of a 2.5 per cent solution (from 0.5 to 1 cc, or 8 to 16 minims of such solu- tion). Alercuric succinimide may be given by the mouth in doses of from 0.01 to 0.015 Gm. (% to Vi grain). Sterile Ampoules Mercury Succinimide 0.01 Gm. (j4 grain): Mercuric succinimide-U. S. P., 0.01 Gm., in water, 1 cc. Prepared by the Abbott Laboratories, North Chicago, 111. Ampules Solution Mercttry Succinimide % grain (0.01 Gm.) 1 cc: Mercuric succinimide-U. S. P. 0.01 Gm. benzyl alcohol 0.01 cc, and glycerin 0.013 Gm., in sufficient distilled water to make 1 cc. Prepared by the Cheplin Biological Laboratories, Inc., Syracuse, N. Y. No U. S. patent or trademark. Glaseptic Ampoules Mercury Succinimide-P. D. & Co., 0.01 Gm. (14, grain): Each cubic centimeter contains mercuric succinimide- U. S. P., 0.01 Gm.; apothesine, 0.005 Gm. ; in distilled water, 1 cc. Prepared by Parke, Davis & Co., Detroit. Ampuls Mercury Succinimide, % grain. Prepared by Sharp & Dohme, Philadelphia and Baltimore. Hypodermic Tablets Mercuric Succinimide 0.012 Gm. (Ys grain). Prepared by Sharp & Dohme, Philadelphia and Baltimore. Mercury Succinimide-Merck. — A brand of mercuric sue cinimide-U, S. P. Merck & Co., Inc., Rahway, X. J., distributor. MERCURY COMPOUNDS 289 MERCUROCHROME. — Mercurochrome Soluble. — NaOGC.CeH.C: CeHsBr: OC6HBr(ONa)(HgOH).3H20.— The I ^ — o ^1 clisodium salt of 2 : 7-dibromo-4-hydroxymercurifluorescem, con- taining 24 to 26 per cent of mercury. Actions and Uses. — Mercurochrome is a nonirritating mod- erately active antiseptic. When applied to the skin, mucous membranes and wounds it exerts bacteriostatic and bactericidal action. The 2 per cent aqueous solution of Mercurochrome acts more slowly than Tincture of lodine-U. S. P., but has more prolonged bacteriostatic effect. The aqueous-alcohol-acetone solution called Surgical Solution of Alercurochrome is more rapid in its action than the aqueous solution and may be used for preoperative skin sterilization. Mercurochrome penetrates significantly only into dying or dead tissue. The drug is tolerated in a strength of 1 per cent by the blad- der, renal pelvis and urethra ; a 2 per cent solution applied to the anterior urethra causes only temporary discomfort. When tested by intravenous injection into rabbits, the danger point is reached with a dosage of 25 mg. per Kg., and 5 mg. causes a decrease in phenolsulfonphthalein excretion and an albuminuria which lasts about a week. Dogs are more resistant. No sys- temic effects have been observed following its local application in the human. Mercurochrome has been used in cystitis and urethritis ; also in affections of the eye and affections of the ear, such as otitis media. The drug has also been injected intravenously in the treat- ment of septicemias and of local infections (subcutaneous abscess following severe injury, retroperitoneal abscess fol- lowing bladder instrumentation, etc.). The drug seems to have given better results against organisms of the colon group; although it has seemed to give good results in some cases of staphylococcus and streptococcus septicemia, it is often times without effect. The intravenous injection is usually but not invariably followed by a transient high temperature and vomiting and sometimes by a severe diarrhea and prostration. Cases of mercurial stomatitis have also been observed following this procedure, and now and then the patient goes into a severe collapse. The physician should realize that intravenous use of this drug may result in such severe symptoms that it should be looked upon as purely an emergency hospital procedure. The effect of Mercurochrome injected intravenously may be due in part to its action upon bacteria causing the infection and in part to nonspecific actions attributable to the colloidal properties of the substance. Dosage. — In the treatment of infections of the kidney pelvis, the ureters are catheterized and the pelvis gently filled with a 1 per cent solution ; the catheter is plugged and the solution retained for five minutes. In the treatment of bladder con- ditions. 25 to 30 cc. of the 1 per cent solution is introduced into the bladder and retained for one hour or lonser, the 290 NEW AND NONOFFICIAL REMEDIES treatment being given daily or on alternate days, or at longer intervals according to circumstances. In anterior gonococcus urethritis, the anterior urethra is filled with a 1 per cent solution and the solution retained for five minutes. If the posterior urethra be involved, the solution is gently retained for an hour or more. In rare cases, considerable irritation is produced, particularly in those with residual urine. Later, in the treatment of acute anterior gonorrhea, a 2 per cent solu- tion is used every three hours. The dose by intravenous injec- tion has usually been 5 mg. per Kg, of body weight ; it is preferably administered in a 0.4 per cent solution, freshly pre- pared from recently distilled water and filtered before using. Solutions are self-sterilizing and should not be boiled. They should be made up from the drug itself, as the tablets are not suitable for this purpose, Mercurochrome is incompatible with acids, with the salts of most alkaloids and with most local anesthetics. The aqueous solution stains the skin red but the discoloration may be removed by a washing in a solution of sodium hypochlorite (solution of chlorinated soda). Manufactured by Hynson, Westcott & Dunning, Baltimore, by license of E. C, White, U. S. patent 1,535,003 (April 21, 1925; expires 1942). U. S. trademark 197,189. Mercurochrome 2 Per Cent Aqueous Solution. Sealed Tubes Mercurochrome, 0.5 Cm. Surgical Solution of Mercurochrome. — Mercurochrome 2 per cent dis- solved in a vehicle consisting of 55 parts of 95 per cent alcohol-U. S. P., 10 parts of acetone-U. S. P., and 35 parts of water, to which has been added sodium carbonate in the proportion of 0.1 per cent. Tablets of Mercurochrome: Each contains 4.6 grains. Mercurochrome occtirs as iridescent, green scales or granules; odor- less; permanent in the air. It is freely soluble in water; practically insoluble in alcohol; insoluble in chloroform or ether. On incineration mercurochrome yields an ash containing sodium bromide and sodium carbonate. The aqueous solution (1 in 10) of mercurochrome is of a deep cherry- red color; on dilution with water it becomes fluorescent. The aqueous solution is stable in the air, does not precipitate proteins and does not respond to the usual tests for mercury ions. Add a few drops of hydrochloric acid to about 10 cc. of an aqueous solution of mercuro- chrome (1 in 100): an orange-red precipitate is given and, if the mix- ture be filtered, the filtrate is nearly colorless, or only slightly yellow. Dry about 1 Gm. of mercurochrome, acurately weighed, to constant weight over sulfuric acid: the loss does not exceed 10 per cent. Dissolve about 1 Gm. of mercurochrome, accurately weighed, in about 50 cc. of water at 50-60 C., filter through a weighed Gooch crucible, wash the residue thoroughly until the washings have only a slight color, dry at 110 C. and weigh: the insoluble matter amounts to not more than 0.2 per cent of the weight taken. Place about 0.2 Gm. of finely powdered mercurochrome, dried to constant weight over sulfuric acid, accurately weighed, in an 800 cc. Kjeldahl flask and slowly add 10 cc. of sulfuric acid, in such a way as to wash down any adherent par- ticles. Mix the materials carefully, heat to a temperature of from 60 to 75 C., remove the flame and add, little by little, finely powdered potassium permanganate, mixing thoroughly after each addition, until the presence of a considerable excess of brown manganese compounds is noted. The appearance of a slight flame after the addition of each portion of the oxidizing agent is immaterial. Cool the mixture to room temperature, add 100 cc. of water, then gradually add powdered oxalic MERCURY COMPOUNDS 291 acid with shaking until the solution becomes clear. Filter if necessary, make the volume to about 200 cc. with water, pass in hydrogen sulfide. collect the precipitate in a Gooch crucible, dry at 100 C. and weigh: the weight of mercuric sulfide corresponds to not less than 24 or more than 26 per cent of mercury. Mercurochrome Suppository Aces: Suppositories representing a 2 per cent solution of mercurochrome (H. W. & D.) in a slightly aromatized hydro-glycero-gelatin base: each suppository weighs approximately 6.5 Gm. (100 grains) and contains V\2 per cent of a mixture of equal parts of phenol, thymol, eucalyptol and menthol. Prepared by Aces Laboratory, Inc., Peekskill, N. Y. Mercurochrome Applicators: Mercurochrome (H. W. & D.), 10 per cent and acacia dried on one end of 3 inch wooden sticks. Prepared by the Arzol Chemical Company. Nyack, N. Y. (J. Sklar Manufacturing Company, Brooklyn, N. Y., distributor.) Saf-T-Top Mercvroclirome Solution, 2 per cent, 2 cc: An aqueous 2 per cent solution of mercurochrome marketed in ampules having a capillary opening, containing 2 cc. Prepared by Robert A. Bernhard, Rochester, N. Y. Saf-T-Top Mercurochrome Solution, 2 per cent, 15 cc. : An aqueous 2 per cent solution of mercurochiome marketed in ampules with a capillary opening, containing 15 cc. Prepared by Robert A. Bernhard, Rochester, N. Y. Saf-T-Top Mercurochrome 2 per cent in 25 per cent Glycerine: A solution of mercurochrome, H. W. & D., 2 per cent in a solution of 25 per cent glycerin, marketed in ampules with a capillary opening, con- taining 2 and 15 cc. Prepared by Robert A. Bernhard, Rochester, N. Y. Ampules Mercurochrome-H. W . & D., 1%, 10 cc: An aqueous 1 per cent solution of mercurochrome, stabilized with 0.18 per cent of ammo- nium hydroxide; in 10 cc. ampules. Prepared by G. D. Searle & Co., Inc., Chicago, 111. Ampules Mercurochrome-H. W . & D., 1%,20 cc. : An aqueous 1 per cent solution of mercurochrome, stabilized with 0.18 per cent of ammo- nium hydroxide; in 20 cc. ampules. Prepared by G. D. Searle & Co., Inc., Chicago, 111. MERCUROL. — Hydrargyri Nucleinas. — Mercury Nucleinate. — An organic compound of mercury with nucleinic acid from yeast, containing 20 per cent of metallic mercury. Actions and Uses. — Mercurol does not coagulate albumin ; it has marked bactericidal power and possesses the pharma- cologic action of soluble mercury compounds. It is said to be useful as a local antiseptic application and as an antisyphilitic remedy. Dosage. — From 0.03 to 0.12 Gm. (^ to 2 grains). It is supplied only in the form of mercurol and iodalbin tablets. (See under Iodalbin.) Manufactured by Parke, Davis & Co., Detroit. U. S. patent 637,355 (Nov, 21, 1899; expired). Mercurol is prepared by adding a solution of mercuric chloride to an alkaline solution of nuclein, containing an excess of alkali, pre- cipitating the resulting nucleinate of mercury by the addition of alcohol and a concentrated solution of a neutral salt (sodium chloride), separat- ing the precipitate, washing and drying it. It is a brownish-white powder, soluble in water, especially in warm water, insoluble in alcohol. Its watery solution has a distinct metallic taste and a weak alkaline reaction, and is not precipitated by alkalis or by albuminous liquids. The mercury in this preparation resists the action of hydrogen sul- fide to a marked degree. 292 NEW AND NONOFFICIAL REMEDIES MEROXYL. — A mixture containing approximately 50 per cent of the sodium salt of 2,4-dihydroxy-3,5-dihydrox-mercuri- benzophenone-2'-sulfonic acid, HgOH O / O-ii-OoH I I \ SOsNa OH HgOH with foreign matter consisting of ammonium 2,4-dihydroxy- benzophenone-2-sulfonate, sodium acetate and water. Actions and Uses. — A local antiseptic and germicide recom- mended for superficial infections by Young, White, Hill and Davis (Surgery, Gynecology and Obstetrics 36:508 [April] 1923). It is used for wet dressings of wounds, and also for irrigation of wounds and of infected bladders. When injected intravenously in animals, the toxicity was found to be high; by oral administration, however, the drug showed a much lower degree of toxicity. Dosage. — For wet dressings of wounds and irrigation of infected wounds, a 0.1 per cent solution is used. For prophy- lactic treatment of urinary infection, postoperative cystitis, acute gonorrhea, abscess and carbuncle, a 0.5 per cent solu- tion is employed. Solutions of 2.5 per cent or greater strength gelatinize on standing. Manufactured by Hynson, Westcott & Dunning, Baltimore. No U. S. patent or trademark. Meroxyl Tablcts-H. IV. & D.: Each tablet contains meroxyl, 0.15 Gni. (2.3 grains). Meroxyl occurs as a flesh colored or pink powder easily soluble in hot water up to 10 per cent. Solutions of 2.5 per cent or stronger gel or form a deposit on cooling. The color of the solution varies with concentration; a 0.5 per cent solution has a brownish-pink color with greenish fluorescence, the color becoming browner in more concentrated solutions. The solution produces no stain on skin or fabrics. Add 1 cc. of sodium hydroxide solution to 1 cc. of meroxyl solu- tion, 1 per cent: no precipitate forms. Add 1 cc. of potassium iodide solution to 10 cc. of meroxyl solution, 1 per cent: no precipitate forms. (If the solution is made neutral or slightly acid with acetic acid, a precipitate is formed.) Add 1 cc. of ammonium sulfide solu- tion to 5 cc. of meroxyl solution, 1 per cent: a black precipitate of mercuric sulfide occurs. Add 3 cc. of sodium hydroxide solution to 3 cc. of meroxyl solution, 10 per cent; the odor of ammonia develops. Add a few drops of diazotized paranitraniline to 2 cc. of a slightly alkaline solution of meroxyl, 0.5 per cent: an intense bordeaux color appears. Add a few drops of a sodium hypochlorite solution to 2 cc. of meroxyl solution, 0.5 per cent: an intense orange color is produced and a fine flaky precipitate forms slowly. Treat 1 Gm. of meroxyl with SO cc. of boiling water: (the insoluble matter does not exceed 0.1 per cent). Assay the product according to the method given under mercuro- chrome: the mercury content is not less than 26 per cent, nor more than 29 per cent, MERCURY COMPOUNDS 293 MERTHIOLATE.— Merthiolate Sodium.— Sodium Ethyl- mercuri Thiosalicylate.— CoHsHg.S.QHiCOONa. Merthiolate contains from 49.15 to 49.65 per cent of mercury in organic combination. Actions and Uses. — Merthiolate, Lilly, is a potent germicide for spore-bearing and non-spore-bcaring bacteria and is also a fungicide. It is used for sterilizing tissue surfaces. It does not precipitate with serum proteins. Merthiolate is much less toxic than mercuric chloride. Rabbits tolerated intravenous doses of 0.020 Gm. to 0.025 Gm. per Kg., and rats as much as 0.045 Gm. when injected slowly, the animals being observed in both cases for seven days. Hemolytic tests with washed rabbit red blood cells indicate that merthiolate has relatively low hemolytic activity. Dosage. — For disinfection of instruments, 1 in 1,000 aqueous solution; for application to the intact skin, tincture 1 in 1,000; for application in wounds and to denuded surfaces, aqueous solu- tion 1 in 1,000; for ophthalmological use, from 1 in 10,000 to 1 in 5,000 aqueous solution ; for application to nasal mucous membranes, from 1 in 5,000 to 1 in 2,000 aqueous; for urethral irrigations, 1 in 30,000 to 1 in 5,000 aqueous. Manufactured by Eli Lilly & Co., Indianapolis. U. S. patent 1,672,615 (June 5, 1928; expires 1945). U. S. trademark 252,182. Merthiolate Jelly 1:1,000: Merthiolate 0.1 per cent, eucalyptol 0.016 per cent, and eugenol 0.016 per cent, in a water-soluble base. Merthiolate Ointment 1:2,000: Merthiolate 0.05 per cent in a petro- latum base. Merthiolate Ophthalmic Ointment, 1:5000: Contains merthiolate 1 part, in 5,000 parts of a base consisting of liquid petrolatum and wool fat with small amounts of paraffin, white petrolatum and ceresin. Merthiolate Solution 1:1,000: One gram of merthiolate and 1 Gm. of monoethanolamine in 1,000 cc. of water, buffered with 1.4 Gm. of sodium borate in 1,000 cc. and containing sodium chloride to make the solution approximately isotonic. Tincture Merthiolate, 1:1000: Contains merthiolate, 0.1 Gm., and monoethanolamine, 0.1 Gm., dissolved in alcohol, 50 cc; acetone, 10 cc, and water, sufficient to make 100 cc. Merthiolate occurs as a light cream colored nonhygroscopic crystalline powder, having a slight odor. It is stable in air but unstable in sun- light. One part by weight of merthiolate dissolves in approximately 1 part of water or in approximately 8 parts of 95 per cent alcohol. It is practically insoluble in ether and benzene. A 1 per cent solution in water has a pH value of about 6.7. Add diluted sulfuric acid to a solution of merthiolate: a white pre- cipitate of ethylmercurithiosalicylic acid is produced. Recrystallize this product from 95 per cent alcohol and dry in a vacuum over sulfuric acid; it melts at 111-114 C. Bubble carbon dioxide into a 1 per cent solution of merthiolate: a precipitate is produced which is soluble in sodium hydroxide. Add a few drops of silver nitrate solution to a 1 per cent solution of merthiolate: a white precipitate separates. Add a few drops of lead acetate solution to a 1 per cent solution of merthiolate: a white precipitate separates. Add a few drops of copper sulfate solution to a 1 per cent solution of merthiolate: a green pre- cipitate separates. Shake 0.5 Gm. of merthiolate, accurately weighed, with 20 cc. of anhydrous ether for ten minutes; filter, evaporate- the ether and dry in a vacuum over sulfuric acid to constant weight: the weight of the residue does not exceed 0.003 Gm. Dissolve about 0.2 Gm. of mer- thiolate in 5 cc of sulfuric acid: not more than a slight yellow color is 294 NEW AND NONOFFICIAL REMEDIES produced. Mix equal parts of a 1 per cent solution of merthiolate and ammonium sulfide: a white precipitate is formed, but no blacken- ing occurs after standing forty-eight hours. Dry 0.1 Gm. of mer- thiolate to constant weight in a vacuum over sulfuric acid: it does not lose more than 0.5 per cent in weight. Transfer to a platinum dish about 1 Gm. of merthiolate, acurately weighed; add 3 cc. of sulfuric acid and evaporate; add 2 cc. of sul- furic acid and evaporate; add 2 cc. of sulfuric acid and evaporate; introduce into the dish a small piece of ammoniuni carbonate and heat until it is volatilized, cool in a desiccator and weigh: The sodium is not less than 5.1 per cent nor more than 5.7 per cent. Transfer about 0.2 Gm. of merthiolate, accurately weighed, to a 100 cc. Erlenmeyer flask; add 3 cc. of sodium hydroxide solution, 10 cc. of water, 20 cc. of sodium sulfide solution (50 Gm. crystals dissolved and diluted to make 100 cc.) and 0.25 Gm. of sodium hydrosulfite; boil under a reflux for twenty minutes; transfer to a weighed platinum dish, dilute to 105 cc. and electrolyze at 4 volts for seventeen hours; remove the solution; wash the dish with water; dry the dish by evaporating the ether, after washing it with alcohol and then ether; weigh: the mercury is equiva- lent to not less than 49.1 per cent nor more than 49.6 per cent. Saf-T-Top Tincture of Merthiolate 1:1000: Tincture of merthiolate 1 : 1000 marketed in Saf-T-Top containers (glass ampules having a capil- lary opening) containing 2 cc. and 15 cc. Marketed by Robert A. Bernhard, Rochester, N. Y. MERBAPHEN.— Novasurol— "The double salt of sodium mercurichlorphenyl oxyacetate with diethyl-barbituric acid, con- taining when dried to constant weight at 100 C, not less than 33 per cent and not more than 34.5 per cent of Hg." U. S. P. For standards see the U. S. Pharmacopeia under Mer- baphenum. Actions and Uses. — Merbaphen was introduced originally as an antisyphilitic, but seems to be used chiefly as a diuretic. It induces diuresis only provided sufficient renal tissue is still intact and is therefore contraindicated in acute diseases of the kidney as well as in advanced nephritis. It is effective in ascites and edema of cardiac and cardiorenal origin. It is usually not effective in ascites resulting from cirrhosis of the liver. It has been tried in hydrothorax, in pericardial effusion and in the ascites of tuberculous peritonitis, but without uniform results. The best results are achieved when merbaphen is employed in conjunction with other diuretic measures: the use of acid-producing salts, and the low fluid, low salt diet. Dosage. — The dose as a diuretic ranges from 1 to 2 cc. of the 10 per cent solution injected intramuscularly or intrave- nously. It is recommended that 0.5 cc. be given first, in order to determine the patient's tolerance for mercury. If the drug is well borne, the dose may be increased to 1 cc. or up to 2 cc, according to the effect observed. The drug is given once or twice a week. Digitalis may be given as indicated. Novasurol. — A brand of merbaphen-U. S. P. Manufactured by Winthrop Chemical Company, New York. U. S. patents 1,034,092 (July 30, 1912; expired) and 1,074,781 (Oct. 7, 1913; expired). U. S. trademark 106,829. Novasurol Ampules: Each ampule contains 1 cc. of a 10 per cent solution of novasurol and metacresol, 0.05 per cent. MERCURY COMPOUNDS 295 METAPHEN. — The anhydride of 4, nitro-5-hydroxy- mercuri-or//io cresol. C6H2.CH3.0.N02.Hg. When metaphen is dissolved in alkah solution, the anhydride ring opens, forming the resulting sodium derivative. Metaphen contains from 56 to 57 per cent of mercury in organic combination. It is used only in form of the sodium salt. Actions and Uses. — Metaphen is a germicide, more powerful than mercuric chloride and certain organic mercury compounds when tested on cultures of Staphylococcus aureus and Bacillus typhosus. It is stated to be relatively nonirritating when applied to mucous membranes or the skin and to be without deleterious action on metallic instruments or rubber. Metaphen is claimed to be relatively non-toxic; white rats were found to survive doses of 0.006 Gm. per kilogram of body weight when injected intravenously, whereas some died in from 1 to 7 days when injected with 0.07 Gm. per kilogram. When injected intra- muscularly, they tolerated (with but slight pain) doses of 0.03 Gm. per kilogram. Metaphen is proposed for use in the treatment of gonorrhea and infections of the eye ; for skin sterilization and for steriliza- tion of instruments and rubber. Dosage. — Solutions of metaphen in water are prepared with the aid of sodium hydroxide. For disinfection of instruments solutions of 1 in 5,000 to 1 in 1,000; for application to the skin solutions of 1 in 5,000 and 1 in 1,000; for ophthalmological and for urethral irrigation solutions of 1 in 5,000 to 1 in 10,000 are proposed. Manufactured by the Abbott Laboratories, North Chicago. U. S. patent Reissue 17,563 (Sept. 22, 1925; expires 1942). U. S. trademark No. 205,507. Metaphen Solution 1:500: 1 part metaphen dissolved in 500 parts of water by means of sodium hydroxide (four molecules of NaOH for every molecule of metaphen) forming metaphen sodium. Metaphen Solution 1:2,500: 1 part metaphen dissolved in 2,500 parts of water containing 0.33 per cent each of sodium bicarbonate and sodium carbonate forming metaphen sodium. Tincture Metaphen 1:200: Metaphen 0.5 Gm., dissolved in a liquid composed of acetone 10 cc, water 40 cc, and alcohol 50 cc. Metaphen is a yellow, odorless and tasteless substance; insoluble in water, almost insoluble in methyl alcohol, acetone, ether and aqueous sodium carbonate and sodium bicarbonate solution; soluble in dilute aqueous sodium hydroxide solution and in ammonium hydroxide solu- tion; soluble in boiling glacial acetic acid and in nitric acid at room temperature. Suspend 0.1 Gm. of metaphen in 10 cc. of glacial acetic acid, allow to stand for five rninutes, decant and wash the residue three times by decantation with distilled water; repeat the procedure three times, then dissolve the residue in 15 cc. of distilled water and 1 cc. of 50 per cent sodium hydroxide solution; add 0.5 Gm. of sodium hydrosulfite and heat to boiling: a heavy deposit of metallic mercury is obtained (combined mercury). Add 50 cc. of benzene to 0.5 Gm. of metaphen, shake for two minutes, filter, and evaporate the filtrate to dryness: the residue does not weigh more than 0.005 Gm. (absence of uncombined 4-nitro-2-cresol). Dissolve 0.4 Gm. of metaphen in 3 cc. of 15 per cent sodium hydroxide solution and 30 cc. of water; divide into two equal portions and transfer to two test tubes; to one add 0.1 (3m. of sodium hydrosulfite, allow to stand for one hour, filter and compare 296 NEW AND NONOFFICIAL REMEDIES the filtrate with the other tube: the first tube is no darker than the control (absence of dinitrocresol) . Treat 0.1 Gm. of metaphen with 20 cc. of 1 per cent sodium hydroxide solution: no insoluble residue remains (absence of inorganic mercury salts or mercury derivative of nitroindazolc). Transfer about 0.2 Gm. of metaphen, accurately weighed, to a dry Erlenmeyer flask; add 2 Gm. of potassium permanganate, mix well, and then add 5 cc. of diluted sulfuric acid; allow the solution to stand for 15 minutes; then carefully add 15 cc. of sulfuric acid (concen- trated) in 2 cc. portions, and allow the mixture to stand for another 10 minutes. Decolorize the mixture drop by drop with hydrogen per- oxide solution; after decolorization add 5 cc. of water and boil for from five to eight minutes. Cool, add 15 cc. of water and saturate the solution with hydrogen sulfide; keep the solution saturated for 18 hours. Transfer the precipitated mercuric sulfide to a Gooch cru- cible; wash with hydrogen sulfide water, then with hydrogen sulfide water acidified with sulfuric acid; wash thoroughly with distilled water, then with alcohol and carbon disulfide. The carbon disulfide should remain over the precipitate for approximately one-half hour. Wash finally with acetone. Dry in an oven for one-half hour at 100 to 110 C. and weigh the mercuric sulfide: the amount of mercury calculated from the weight of the mercuric sulfide is not less than 56 per cent, nor more than 57 per cent in the dried substance. Saf-T-Top Tincture Metaphen: Tincture of metaphen 1:200, marketed in ampules having a capillary opening, containing 2 cc. and 15 cc. Prepared by Robert A. Bernhard, Rochester, N. Y. POTASSIUM MERCURIC IODIDE.— Potassii Hydrargyri lodidum. — A complex salt, K^HgL, formed by the interaction of one molecule of mercuric iodide with two molecules of potassium iodide and containing about 25.5 per cent of mercury. Actions and Uses. — Potassium mercuric iodide is used for the same purposes as mercuric iodide, over which it has some advantages because of its solubility. As a germicide it is effective, as it does not coagulate albumin ; however, there seems to be no work to show how much the activity is decreased when an excess of potassium iodide is present. In comparison with mercuric chloride it is claimed to have a greater safety factor : Weight for weight, potassium mercuric iodide is about one half as toxic as mercuric chloride according to animal experiments ; in proportion to the mercury content, however, potassium mercuric iodide and mercuric chloride possess about the same toxicity. Externally, potassium mercuric iodide is used for skin dis- infection, irrigations and disinfection of instruments and of excreta and discharges. Dosage. — As a germicide it is used in concentrations of 1 in 100 to 1 in 10,000. For irrigation of wounds, it is desir- able to render the solution isotonic by addition of 0.9 per cent sodium chloride. Solutions of potassium mercuric iodide may be prepared : (1) By dissolving 1 part by weight of mercuric iodide and 1 part by weight of potassium iodide in a small amount of water and then diluting to proper strength ; such a solution will contain about 20 per cent excess of potassium iodide, MERCURY COMPOUNDS 297 sufficient to prevent precipitation of mercuric iodide from dilute solutions of the complex salt. (1 Gm. mercuric iodide is equiva- lent to 1.7 Gm. potassium mercuric iodide.) (2) By dissolving potassium mercuric iodide in water con- taining potassium iodide. Solutions made from potassium mercuric iodide alone have a tendency to decompose with precipitation of mercuric iodide ; hence it is necessary to have present an excess of potassium iodide equivalent to about 20 per cent by weight of the amount of potassium mercuric iodide used. Germicidal Discs of Potassio-Mercuric lodide-P. D. & Co.: Disc- shaped tablets of potassium mercuric iodide containing an excess of potassium iodide, colored blue. Each disc represents mercuric iodide, 0.U971 Gm. (11/^ grains); potassium iodide, 0.0971 Gm. (1^ grains); sodium bicarbonate, 2.9259 Gm. (45 grains). Prepared by Parke, Davis & Co., Detroit. No U. S. patent or trade- mark. Germicidal Discs of Potassio-Mercuric lodide-P. D. & Co.: Disc- shaped tablets of potassium mercuric iodide containing an excess of potassium iodide, colored blue. Each disc represents mercuric iodide, 0.0283 Gm. (^s grain); potassium iodide, 0.0283 (^ grain); sodium bicarbonate, 1.0368 Gm. (16 grains). Prepared by Parke, Davis & Co., Detroit. No. U. S. patent or trade- mark. Kalmerid Germicidal Tablets Potassium Mercuric Iodide: Each tablet contains potassium mercuric iodide, 0.5 Gm. (7.72 grains); potassium iodide, 0.37 Gm. (5.7 grains); ammonium chloride, 0.125 Gm. (1.83 grains); an eosin "Y," 0.005 Gm. (0.077 grain). Prepared by Davis & Geek, Inc., Brooklyn, N. Y. U. S. patent 1,276,119 (Aug. 20, 1918; expired). U. S. trademark 116,042. Potassium mercuric iodide occurs as yellow crystals, deliquescent in air. It is soluble in alcohol and in potassium iodide solution. It yields a clear solution with one part of water. When the solution is diluted with much water, mercuric iodide precipitates slowly; but if one fifth of its weight of potassivmi iodide is previously added to the salt or its concentrated solution, no mercuric iodide separates on dilution. Its aqueous solution is slightly alkaline to litmus. When the salt is heated in a test tube to the point of fusion, it becomes red, but on cooling again assumes a yellow color; at higher temperatures, there is volatili- zation of mercuric iodide. Treat about 0.2 Gm. of potassium mercuric iodide with 1 cc. of water and add 1 cc. of chloroform and 0.5 cc. of ferric chloride solu- tion: the chloroform shows the characteristic color of iodine. Treat about 0.1 Gm. of the salt with 2 cc. of sodium hydroxide solution, and add a few drops of formaldehyde solution: a black precipitate of metallic mercury is produced. Potassium mercuric iodide loses not more than 4 per cent of its weight when dried at 120 C for four hours. Transfer about 1.5 Gm. of potassium mercuric iodide, accurately weighed, to a 100 cc. volumetric flask, and dissolve in 1.5 cc. of water, then dilute to 100 cc. Pipette immediately 10 cc. of the solu- tion into a glass stoppered 250 cc. bottle and add 35 cc. of hydrochloric acid and 5 cc. of chloroform. Titrate the solution with tenth-normal potassium iodate (10.701 Gm. in 1,000 cc), stoppering the bottle and shaking the contents well after each addition. The addition of the potassium iodate solution is continued until the iodine which was first liberated disappears, and the chloroform shows no pink color: the iodine content, calculated to the dry salt, is not less than 63.4 per cent nor more than 65.5 per cent. Dissolve about 2.5 Gra. of potassium mercuric iodide, accurately weighed, in about 10 cc. of water, and add sufficient potassium iodide 298 NEW AND NONOFFICIAL REMEDIES solution to prevent precipitation of mercuric iodide. Introduce the solution and washings into a cathode cup, previously weighed with its metallic mercury, and add 10 cc. of sodium hydroxide solution, 20 per cent. Pass through the solution an electric current, gradually increas- ing the current so that at the end of eight minutes it will be 2 to 3 amperes and 7 to 10 volts, stirring the solution by rotating the anode about 500 revolutions per minute. After forty minutes, wash with distilled water, with the aid of a siphon and without interrupting the current until the current drops to zero. Remove the cathode cup and allow it to stand with 20 cc. of acetic acid solution, 3 per cent, until bubbles cease to be evolved. Wash the mercury with water, and then alcohol, remove most of the excess alcohol by filter paper, then dry in a desiccator over potassium hydroxide sticks and a beaker of mercury. The increase in the weight in the cathode cup represents the amount of mercury present in the quantity of the salt taken. The mercury content of potassium mercuric iodide, calculated to the dry salt, is not less than 25.0 per cent, nor more than 26.0 per cent. RED MERCURIC IODIDE.— "Contains, when dried to constant weight over sulfuric acid, not less than 99 per cent of Hgla. Caution: Red Mercuric Iodide is extremely poisonous." N. F. For standards see the National Formulary under Hydrargyri lodidum Rubrum. SALYRGAN. — Mersalyl. — Sodium [o(hydroxymercuric- methoxypropylcarbamyl) phenoxy] acetate. — NaOOC.CHaO. C6H4CONH.C3H5(O.CH3)(HgOH). Salyrgan is a complex synthetic mercurial, prepared by the action of mercury acetate and methyl alcohol on salicylallylamido-o-acetic acid and sub- sequent conversion to the sodium salt. Salyrgan when dried to constant weight contains 39.6 per cent of mercury in non- ionizable form. Actions and Uses. — Salyrgan has been demonstrated to exert a destructive action on the spirochete of syphilis in rabbits, but is used chiefly as a diuretic. It induces diuresis only pro- vided sufficient renal tissue is still intact and is therefore contra- indicated in acute diseases of the kidney as well as in advanced nephritis. It is effective in ascites and edema of cardiac and cardiorenal origin. It is usually not eft'ective in ascites resulting from cirrhosis of the liver. It has been tried in hydrothorax, in pericardial effusion and in the ascites of tuberculous peritonitis, but without uniform results. The best results are achieved when salyrgan is employed in conjunction with other diuretic measures : the use of acid-producing salts, and the low fluid, low salt diet. On the whole salyrgan is probably a little better diuretic and definitely less toxic than merbaphen. Dosage. — Salyrgan is supplied only in the form of a 10 per cent solution. As a diuretic, an initial dose, intramuscularly or intravenously, of 0.5 cc. of the solution to test tolerance, increased to 1 cc. or to a maximum of 2 cc. if required; injec- tions are made at intervals of from three to five days. Manufactured by Winthrop Chemical Co., Inc., New York. U. S. patent 1,693,432 (Nov. 27, 1928; expires 1945). U. S. trademark 188,515. Ampules Salyrgan Solution, 1 cc: Each ampule contains 1 cc. of a 10 per cent solution of salyrgan. MERCURY COMPOUNDS 299 Ampules Salyrgan Solution, 2 cc. — Each ampule contains 2 cc. of a 10 per cent solution of salyrgan. Salyrgan occurs as a white, crystalline, odorless powder with a bitter taste; readily soluble in ethyl alcohol, about 1 in 3, methyl alcohol, about 1 in 2 and water, about 1 in 1, and insoluble in ether. An aqueous solution is alkaline to litmus paper. Dissolve 0.5 Gm. in 5 cc. of water, add 5 cc. of formic acid (90 per cent) and boil the mixture under a reflux condenser for fifteen minutes: the precipitate formed dissolves, leaving a gray residue containing fine globules of metallic mercury. Filter the mixture through paper while hot; allow the filtrate to cool, collect the resultant salicylallylamido-^- acetic acid crystals on a filter paper, wash and dry over sulfuric acid in a partially exhausted desiccator: it melts at 120-121 C. Dissolve about 1 Gm. in 10' cc. of water, add 10 cc. of a solution of hydrochloric acid (1 part hydrochloric acid and 1 part water), connect to a condenser, distill oflf about three fourths the volume: the distillate responds to tests for methyl alcohol. Dissolve 0.5 Gm. in 5 cc. of water, add 0.5 cc. of diluted acetic acid and 0.3 cc. of sodium sulfide solution: no colora- tion results (^heavy metals — especially mercuric ions). Dissolve 0.1 Gm. in 5 cc. of water, add 1 cc. of nitric acid, filter through paper and divide the filtrate into two portions; to one portion add 1 cc. of silver nitrate solution: no opalescence results (chlorides); to the other portion add 1 cc. of barium nitrate solution: no turbidity results (sulfates). Dissolve 0.5 Gm. in 10 cc. of water, add 1 cc. diluted sulfuric acid, filter through paper and divide the filtrate into two portions; to one portion add 0.1 cc. of tenth-normal potassium permanganate solution: no immediate decoloration results (salicylallylamido acetic acid) ; to the remaining portion add 0.1 cc. of diluted ferric chloride solution; no violet color develops {salicylallylamide) . When tested for arsenic according to the U. S. Pharmacopeia X, the product meets the require- ments for arsenic (p. 428, Arsenic Test). Dry about 1 Gm., accurately weighed, to constant weight over sul- furic acid in a partially exhausted desiccator: the loss in weight does not exceed 5.0 per cent. Transfer about 0.5 Gm., accurately weighed, to a 500 cc. Kjeldahl flask, and determine the nitrogen content accord- ing to the official method described in Official and Tentative Methods of Analysis of the Association of Official Agricultural Chemists, Sec- ond Edition, p. 8. The percentage of nitrogen corresponds to not less than 2.55 per cent, nor more than 3.0 per cent when calculated to the dried substance. Weigh accurately about 0.5 Gm. in a tared platinum di_sh,_ add 10 cc. of sulfuric acid, gently heat while fumes of sulfur trioxide are evolved, repeat, using two portions of 2 cc. of sulfuric acid, respectively, ignite, cool and weigh as sodium sulfate. The per- centage of sodium corresponds to not less than 4.3 per cent, nor more than 4.9 per cent, when calculated to the dried substance. Transfer about 0.5 Gm., accurately weighed, to an Erlenmeyer flask; add 100 cc. of water and agitate until the powder has dissolved; add 15 cc. hydrochloric acid, connect to a reflux condenser and boil for three hours. Add 175 cc. of hot water, and pass in hydrogen sulfide for fifteen minutes. (It is important that the temperature of the solution should be about 70 C. in order to keep in solution slightly soluble organic compounds formed during hydrolysis). Filter while warm, through a Gooch crucible, wash with distilled water and finally three parts of cold alcohol and then one portion of carbon disulfide. Close the rubber tubing leading from the suction flask to the suction pump with a pinch clamp; add sufficient carbon disulfide to cover the pre- cipitate, cover the crucible with a watch glass and allow to stand one- half hour. Then release the pinch clamp, drain off the solution and wash with several portions of carbon disulfide. Dry in an oven at 100 C, weigh the mercury sulfide and calculate to mercury. The percentage of mercury corresponds to not less than 38.0 per cent, nor more than 41.0 per cent, when calculated to the dried substance. SOLUTION COLLOIDAL MERCURY SULPHIDE- HILLE. — Liquor Hydrargyri Sulfidum Colloidale. — Solution Colloidal Mercuric Sulfide. — A colloidal 2 per cent solution 300 NEW AND NONOFFICIAL REMEDIES of mercuric sulfide in water, stabilized with a hydrolyzed protein substance and preserved with 0.2 per cent of tricresol. Actions and Uses. — Solution colloidal mercury sulphide-Hille is proposed for intramuscular injection in the treatment of syphilis. Dosage. — The usual dose is from 2 to 3 cc. administered intramuscularly twice a week for a course of sixteen to twenty injections. With intermittent treatment there should then be a rest period of six or eight weeks. If continuous therapy is being used, of course some other antisyphilitic, for example arsphenamine, might then be employed. Manufactured by Hille Laboratories, Inc., Chicago. No U. S. patent or trademark. Solution colloidal mercury sulphide-Hille is black in reflected light and brown in transmitted light. It possesses the odor and taste of cresol. It has a specific gravity of from 1.0670 to 1.0690. Solution colloidal mercury sulphide-Hille is neutral to litmus. (Place a drop of the solution over a piece of blue litmus paper and a drop on red litmus paper; after one minute the original color can be detected on the edges of the drop.) To 1 cc. of the original solution add 3 cc. of iodine solution: a clear reddish solution results which within an hour becomes turbid because of the separation of a red precipitate. To 20 cc. of solution colloidal mercury sulphide-Hille add 7 Gm. of sodium chloride and boil until the colloid coagulates, filter off the precip- itate and cool the solution: the yellowish solution remains clear {lead), dilute the filtrate to 25 cc. Transfer about one fourth of the black precipitate to a beaker, add 10 cc. of water, 2 cc. of diluted hydrochloric acid and a small crystal of potassium chlorate, boil until the solution no longer evolves chlorine, filter off the sulfur and add a few drops of stannous chloride: a white precipitate that changes to gray forms. To 5 cc. of the yellowish filtrate add 5 cc. of ammonia water: no color change occurs (copper) and no pre- cipitate forms (bismuth, iron). To 5 cc. of the filtrate add 1 cc. of a 1 per cent solution of tannic acid: a white precipitate forms. To 5 cc. of the filtrate add 2 drops of a 36 per cent solution of acetic acid: a turbidity appears that disappears on the addition of more acetic acid. To 5 cc. of the filtrate add 1 cc. of copper sulfate solution: a slight precipitate forms that is rendered soluble by adding 2 volumes of water; add 1 cc. of normal sodium hydroxide solution: a violet color appears. To 5 cc. of the filtrate add 1 cc. of mercuric chloride solution: no precipitate forms. To 5 cc. of the original solu tion add 5 cc. of diluted hydrochloric acid and a small crystal of potas sium chlorate and heat. When the black precipitate has disappeared filter and boil to a small volume. Add 2 cc. of sulfurous acid and continue the boiling until sulfur dioxide is no longer given off cool: this solution conforms to the U. S. P. X Gutzeit test for arsenic. Transfer exactly 5 cc. of solution colloidal mercury sulphide-Hille to a weighed platinum dish, add sodium sulfide solution (50 Gm. sodium sulfide dissolved to make 100 cc.) until the precipitate just dissolves and then add as much again, electrolyze the solution for six hours using 6 volts, wash with water, alcohol and ether, dry in a desiccato" containing sulfuric acid and a beaker containing metallic mercury, weigh: the mercury calculated to mercuric sulfide is not less than 1.94 per cent nor more than 2.06 per cent. YELLOW MERCURIC OXIDE.— Yellow Precipitate— "When dried to constant weight at 110 C, contains not less than 99.5 per cent of HgO."—U. S. P. For standards see U. S. Pharmacopeia under Hydrargyri Oxidum Flavum. MERCURY COMPOUNDS 301 Compound Yellozv Oxide and Adrenalin Ointmcnt-M. E. S. Co. : Yellow oxide of mercury, 1 per cent; solution of adrenalin chloride, 1 per cent; menthol, 0.04 per cent; phenol, 0.2 per cent; anhydrous wool tat, 10 per cent, and white petrolatum sufficient to make 100 per cent. Put up in collapsible tubes, for application to the eye. Prepared by Manhattan Eye Salve Co., Louisville, Ky. No U. S. patent or trademark. Mercury (Metallic) Preparations MERCURETTES-P. D. & CO.— Tabellae Hydrargyri Cum Oleo Theobromatis. — Briquettes, each containing finely divided metallic mercury 3.25 Gm. (50 grains) incorporated with theobroma (cacao butter) and perfumed. Each briquette weighs 8 Gm. (120 grains). Actions and Uses. — The same as those of ointment of mer- cury-U. S. P. It is claimed that in the treatment of syphilis and certain forms of parasitic skin diseases where ointment of mercury has been employed, the use of mercurettes permits a more accurate dosage and is more convenient and less dis- agreeable. Dosage. — Applied by inunction. If less than one briquette is to be used, it may be divided by cutting with a knife. Prepared by Parke, Davis and Co., Detroit. No U. S. patent. U. S. trademark 180,215. METRAZOL.— Pentamethylenetetrazol.— CH2CH2CH2CH2CH2C=N— N=N— N. I I Actions and Uses. — The action of metrazol is similar to that of camphor, but it is claimed to be more dependable, mainly on account of its greater solubility in water. Its action following injection intravenously or subcutaneously is induced promptly. Metrazol stimulates the vasomotor and respiratory centers in experiments on normal animals, but an experienced worker in this field found it a very uncertain respiratory stimulant in con- ditions of depressed respiration in animals, in which carbon dioxide, epinephrine and ephedrine were markedly effective ; that as a circulatory stimulant it usually caused a rise of blood pressure only in convulsive doses ; that it did make irregularly beating hearts beat more regularly, but only at expense of depression of rate and amplitude. The use of metrazol is reported as a sustaining agent and restorative in chronic cardiac and circulatory insufficiency, in pneumonia, and in other infec- tious diseases. It has been reported to be of value in emer- gencies due to cardiovascular collapse, in shock, in respiratory failure and in narcotic depression. On the other hand, it causes capillary dilatation in the splanchnic region, and animal experiments indicate that the intravenous injection may be dis- tinctly dangerous. It may be combined with digitalis and the xanthine diuretics. 302 NEW AND NONOFFICIAL REMEDIES Dosage. — Intramuscularly, subcutaneously, or intravenously, from 0.1 to 0.3 Gm. (1^ to 4^4 grains) repeated as required; orally, from 0.1 to 0.3 Gm. (1^ to 4j^ grains) several times daily. Manufactured by Knoll A.-G., Ludwigshafen a. Rh., Germany (Bilhuber- Knoll Corporation, Jersey City, N. J., distributor). U. S. patent 1,599,493 (Sept. 14, 1926; expires 1943). U. S. trademark 249,687. Hypodermic Tablets Metrazol V/i grains: Each tablet contains 1^ grains of metrazol. Metrazol Ampules, 1 cc: Each ampule contains 1.1 cc. of a 10 per cent aqueous solution of metrazol. Metrazol Solution 10 per cent: An aqueous solution containing metrazol, 0.1 Gm. per cubic centimeter. Metrazol Tablets: Each tablet contains 1^2 grains of metrazol. Metrazol occurs as biaxial, optically negative, white crystals that are freely soluble in water. It melts at 57-58 C. To a 10 per cent aqueous solution of metrazol add a saturated solu- tion of mercuric chloride: a white solid precipitate results, which may be recrystallized from hot water or alcohol to yield crystals melting at 177-178 C. and leaving not more than 0.1 per cent of ash on incinera- tion. Transfer about 0.2 Gm. of metrazol, accurately weighed, to a wide mouth weighing bottle; allow to stand over calcium chloride: the loss in weight is not more than 0.1 per cent. Transfer about 0.2 Gm. of metrazol, accurately weighed, to a platinum dish and incinerate: the ash is not weighable. Determine nitrogen by the Dumas method as described in Clarke's Handbook of Organic Analysis, ed. 2, New York, Longmans, Green & Co., 1916, p. 199: the nitrogen is not less than 40.4 nor more than 40.9 per cent. NAPHTHOL COMPOUNDS Compounds of naphthol that are insoluble in the stomach have been introduced in therapeutics. The expectation was that, owing to the greater concentration of the naphthol in the intestines after its liberation by the bile and pancreatic juices, these compounds would have a maximum antiseptic action. In addition, the action of whatever substance was united with the naphthol would be exerted, whether on the intestine or on some other part of the body, such as the genito- urinary tract. A wide difference of opinion, however, exists among authori- ties as to the actual efficacy of all intestinal antiseptics and of most urinary antiseptics. Whatever opinion regarding this is held, it should be remembered that any of them, if used freely or for a long time, may have irritating effects on the digestive tract or undesirable effects on other tissues. Reasonable caution should therefore be exercised in using them. BETANAPHTHYL BENZOATE. — Betanaphtholis Benzoas. — Betanaphthol Benzoate. — Benzonaphthol — CeHs COO.CCioHt). — The benzoic acid ester of betanaphthol. Actions and Uses. — Betanaphthyl benzoate is not decomposed by the gastric fluid, but is split into its constituents in the intestinal canal. NITRATES— ORGANIC 303 Betanaphthyl benzoate is used internally as an intestinal anti- septic in diarrhea and typhoid fever. Externally, betanaphthyl benzoate is used as a parasiticide in the form of from a 3 to a 10 per cent ointment. It has been used in psoriasis, eczema, scabies, etc. Dosage. — From 0.2 to 0.5 Gm. (3 to 8 grains) ; maximum dose, single, 1 Gm. (15 grains), daily 4 Gm. (60 grains). Betanaphthyl benzoate occurs in colorless needles, or as a white, tasteless, crystalline powder of faintly aromatic odor. It darkens with age. It is almost insoluble in water, very soluble in alcohol and ether, and soluble in chloroform and fixed oils. It melts at from 107 to 110 C. Betanaphthyl benzoate heated with a solution of potassium hydroxide in alcohol develops the odor of ethyl benzoate; on the addition of chloroform the mixture acquires a blue color. Shake vigorously for one minute 1 Gm. of betanaphthyl benzoate with 20 cc. of a cold 5 per cent aqueous sodium hydroxide solution, and filter immediately. To 10 cc. of the filtrate, add 2 cc. of chloroform, and boil: no blue color is produced in the aqueous layer (uncombined betanaphthol) . Carefully neutralize the remaining 10 cc. of alkaline filtrate, then add a few drops of ferric chloride solution previously diluted with two volumes of water and neutralize, if necessary, with amrnonia water: no pink precipitate is produced {nncombined benzoic acid). Shake vigorously for one minute 0.5 Gm. of betanaphthyl benzoate with 5 cc. of an aqueous 5 per cent sodium hydroxide solution and filter: no blue color develops in the filtrate on the addition of a few drops of iodine solution {alphanaphthol). Shake vigorously for one minute 0.5 Gm. of betanaphthyl benzoate with 50 cc. of distilled water and filter: the filtrate should not be acid toward litmus. Five cc. portions of the filtrate mixed with equal volumes of diluted nitric acid do not become turbid on the addition of 1 cc. of silver nitrate solution {chloride) or of barium nitrate solution {sulfate). Incinerate 0.5 Gm. of betanaphthyl benzoate: not more than 0.1 per cent of ash remains. Betanaphthol Benzoate-Merck. — A brand of betanaphthyl benzoate-N. N. R. Merck & Co. Inc., Rahway, N. J., distributor. No U. S. patent or trademark. BISMUTH BETANAPHTHOL.— See Bismuth Con> pounds. NITRATES— ORGANIC The esters of nitric acid and the higher alcohols (glycerin, propanetriol, erythrite (butanetetrol), etc.) have an action on the blood vessels similar to that of the inorganic nitrites (sodium nitrite) and that of the nitrous acid esters of the alcohols (amyl nitrite, ethyl nitrite). This is generally attributed to the for- mation in the body of nitrites from them. The action of organic nitrates differs from that of the organic nitrites chiefly in that the action of the former is longer continued. This is seen in the case of glyceryl trinitrate-U. S. P. (nitroglycerin), and to a still greater degree, in the following: 304 NEW AND NONOFFICIAL REMEDIES DILUTED ERYTHRITYL TETRANITRATE-U. S. P. — Diluted Erythrol Tetranitrate. — Diluted Tetranitrol. — "Diluted Erythrityl Tetranitrate is a mixture of erythrityl tetra- nitrate and lactose, and occurs as a white powder, or in the form of tablets. The powder contains not less than 47 per cent and not more than 53 per cent of C4H6(N03)4 (302.08). Tablets of Erythrityl Tetranitrate do not vary more than 7.5 per cent above and not more than 7.5 per cent below the labeled amount of erythrityl tetranitrate [C4Hfi(N03)4]." U. S. P. For standards see U. S. Pharmacopeia under Erythritylis Tetranitras Dilutus. Actions and Uses. — Diluted erythrityl tetranitrate is a vaso- dilator like nitroglycerin. Its action is slower and more lasting, beginning in fifteen minutes and persisting for three or four hours. It is said to be useful in angina pectoris and vascular diseases. It is reported as especially useful as a prophylactic in preventing anginal pain. Dosage. — From 0.03 to 0.06 Gm. (^ to 1 grain) every four to six hours. Pure erythrityl tetranitrate is a crystalline mass, which explodes on percussion, hence it is marketed chiefly in the form of tablets. Sold in the form of tablets only. ERYTHROL TETRANITRATE (UNDILUTED).— Erythrityl tetranitrate. — It has twice the strength of diluted erythrityl tetranitrate-U. S. P. Actions, Uses and Dosage. — See under Diluted Erythrityl Tetranitrate. Merck & Co. Inc., Rahway, N. J., distributor. German patent 81,664. Erythrol Tetranitrate Tablets-Merck, Vz grain. Erythrol Tetranitrate Tablets-Merck, 14 grain. OPIUM PRINCIPLES, DERIVATIVES AND PREPARATIONS Morphine is a complex derivative of phenanthrene. It con- tains two OH groups (one phenolic, the other alcoholic) in which substitutions can be made by either alkyl or acid radicals. The more important alkyl esters are the monomethyl (codeine) ; the dimethyl (thebaine) ; and ethyl-morphine. Heroin is the diacetyl derivative. The nature of these radicals — whether acid or alcoholic, aromatic or aliphatic — modifies the actions, quantitatively, but only in degree. Replacement of one hydroxy! group (codeine) diminishes the narcotic action and increases the respiratory and tetanic action. When both OH groups are replaced by acids (diacetyl morphine), the narcotic effects are stronger than with codeine, and the tetanic action is weaker than with morphine. OPIUM PRINCIPLES AND PREPARATIONS 305 Actions and Uses. — The central actions of all these morphine derivatives are qualitatively identical ; but they present quantita- tive differences v^hich have some practical importance : Morphine produces the strongest narcotic analgesic, hypnotic and intestinal effects, and the weakest stimulation. It causes the greatest derangement of digestion. It and diacetyl morphine are most liable to induce a habit. Codeine (methyl-morphine) is less narcotic, less constipating, and less apt to induce tolerance and habit. It is, therefore, especially valuable in cough or in other conditions in which the sedative action must be continued for some time and in patients who do not tolerate morphine. Ethyl-Morphine seems to stand intermediate between mor- phine and codeine, in all respects. The hydrochloride is used as a sedative, but mainly for its special action on the con- junctiva. Diacetyl-Morphine (heroin) closely approaches morphine, of which it shares all the disadvantages, and over which it has no important advantage. It was originally introduced with the claim that therapeutic doses lessen the cough reflex and slow the respiration, but that the inspirations are deepened and more powerful, so that the alveolar air is more effectively ventilated. Independent workers, however, have shown that there is no real difference from morphine in these respects. It is now generally conceded that diacetyl-morphine is as effec- tive as morphine in cough, but not more so ; that it is rather less effective against dyspnea; and that it is more liable to produce habit and toxic effects. Codeine seems to be superior to diacetyl morphine in its power to allay cough, to overcome pain and to promote sleep (Bastedo). DILAUDID HYDROCHLORIDE.— D/hydro-morphinone hydrochloride. — CitHioOsN.HCI. Dilaudid hydrochloride differs essentially from morphine hydrochloride in that one of the hydroxyl groups of the latter has been replaced by a ketone group and the adjacent double bond has been removed by hydrogenation. Actions and Uses. — The base dilaudid is closely allied both chemically and pharmacologically to morphine, having the analgesic property of morphine as well as its action on the respiratory system. Its action on the intestine is probably less marked than is that of morphine. It is more toxic than morphine and is clinically effective in doses which are considerably smaller than are necessary with that alkaloid. It has been shown experimentally and clinically that dilaudid is powerfully anal- gesic and that, like morphine, it can depress the respiratory 306 NEW AND NONOFFICIAL REMEDIES mechanism profoundly. At the same time, the experimentally established ratio between effective doses of morphine and dilaudid for the production of desirable effects is not materially different from the ratio between their toxic doses. Clinical trial has not shown that dilaudid is free from tolerance and addiction evoking properties, and, while side actions such as nausea, vomiting and constipation seem to occur less frequently than with morphine, the prolonged administration of dilaudid should be undertaken with as much caution as would be exer- cised with morphine itself. Dilaudid hydrochloride comes within the scope of the federal narcotic regulations. Dosage.— As a sedative and for the relief of pain, the usual oral dose is 2.5 mg. (^4 grain) ; in mild pain or cough, 1.3 mg. (%,8 grain) may be given orally. The customary hypodermic dose is 2 mg. (^^2 grain). Clinically the dose of dilaudid neces- sary to produce analgesia is about one-fifth that of morphine. Manufactured by E. Bilhuber, Inc., Jersey City, N. J. (Bilhuber- Knoll Corporation, Jersey City, N. J., distributor). No U. S. patent. German patent 380,919 (1923). U. S. trademark 298,197. Ampules Solution DUaudid Hydrochloride, 2 mg. (V^2 grain), 1.1 cc: Each cubic centimeter contains dilaudid, 2 mg., in physiologic solution of sodium chloride. Dilaudid Hydrochloride Compounding Tablets J^ Grain: Each tablet contains dilaudid hydrochloride one-half grain. These tablets, each many times the average dose, are for use in compounding only. Dilaudid Hydrochlai-ide, Rectal Suppositories V24 grain : Each contains dilaudid hydrochloride 0.0026 Cm. (1/24 grain) in a cacao butter base. HypoderrrUc Tablets Dilaudid Hydrochloride, 2 mg. (\^2 grain). Hypodermic Tablets Dilaudid Hydrochloride, 3.2 mg. ('I/20 grain). Hypodermic Tablets Dilaudid Hydrochloride, 4 mg. ^Vie grain). Tablets Dilaudid Hydrochloride, 2.5 mg. ('I/24 grain). Dilaudid hydrochloride occurs as a fine, white, crystalline, odorless powder; freely soluble in water, about 1 in 3; soluble in alcohol; insoluble in ether. Its aqueous solution is neutral to litmus. From aqueous solution, ammonia water and sodium hydroxide precipitate the free base, di'hydromorphinone as fine, white crystals, soluble in an excess of sodium hydroxide. Dissolve about 0.5 Gm. of dilaudid hydrochloride in 25 cc. of water, add sufficient ammonia water to make distinctly alkaline and Jet stand overnight; collect the precipitate of rfihydromorphinone on a filter paper, wash with cold water, dry at 100 C. : it melts with decomposition at 257 to 262 C. To 10 cc. of the foregoing filtrate add an excess of diluted nitric acid and 2 cc. of silver nitrate solution : a curdy white precipitate results, soluble in an excess of ammonia water. Add 0.5 Gm. of dilaudid, previously dissolved in 2 cc. of water, to an aqueous solution containing 1 Gm. of hydroxylamine hydrochloride, warm, fol- lowed by the addition of an excess of ammonia water and set aside overnight; collect the precipitate of oxime on a filter paper, wash with a diluted ammonia water (1 part ammonia water with 99 parts of water) and water, dry at 100 C: it melts with decomposition at 230 to 235 C. Dissolve 0.02 Gm. of dilaudid hydrochloride in 5 cc. of sulphuric acid and add 1 drop of ferric chloride solution and heat gently: no blue coloration results. Dissolve 0.01 Gm. of dilaudid hydrochloride in 1 cc. of water and mix 10 cc. of a freshly prepared potassium ferri- cyanide solution to which previously has been added 0.1 cc. of ferric OPIUM PRINCIPLES AND PREPARATIONS 307 chloride solution: a blue color results {difference from codeine). Boil about 0.2 Gm. of dilaudid hydrochloride with 5 cc. of sodium hydroxide solution: the odor of ammonia is not noticeable {ammonium salts). Dis- solve about 0.5 Gm. of dilaudid hydrochloride in 15 cc. of water: separate portions of 5 cc. each yield no red coloration on dilution with an equal volume of diluted hydrochloric acid and 0.2 cc. of ferric chloride solution (meconate); no turbidity with 1 cc. of diluted hydro- chloric acid and 1 cc. of barium chloride solution (sulfate) ; no colora- tion or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Dry about 0.5 Gm. of dilaudid hydrochloride at 100 C. for six hours: the loss in weight does not exceed 1.5 per cent. Incinerate about 0.5 Gm. of dilaudid hydrochloride accurately weighed: the residue is not more than 0.1 per cent. Transfer about 0.3 Gm. of dilaudid hydro- chloride acurately weighed, to a suitable Kjeldahl flask and determine the nitrogen content according to the official method described in Official and Tentative Methods of Analysis of the Association of Official Agricultural Chemists, third edition, page 20, chapter 2, para- graph 22: the percentage of nitrogen corresponds to not less than 4.25 per cent, nor more than 4.5 per cent when calculated to the dried substance. Transfer about 0.3 Gm. of dilaudid hydrochloride, accurately weighed, to a suitable beaker, add 100 cc. of water, followed by the addition of 25 cc. of silver nitrate solution and 10 cc. of nitric acid, boil with continuous stirring and allow to cool in a dark place. Collect the precipitate of silver chloride on a Gooch crucible, wash with a diluted nitric acid and water, followed by alcohol and ether; finally dry to constant weight at 100 C. : the amount of hydrogen chloride calculated from the silver chloride found corresponds to not less than 11.25 per cent, nor more than 11.5 per cent when calculated to the dried substance. PAPAVERINE.— Papaverina.—CsoHoiO.N.— An alkaloid obtained from opium, belonging to the benzyl isoquinoline group (that is, it is not a morphine derivative). Actions and Uses. — Pal found that papaverine relaxes smooth muscle in general, although different organs are afifected in a varying degree. Papaverine is most effective in hypertonic conditions, while it does not interfere materially with the normal movements, for instance, of the intestines. It is also a rather feeble cen- tral analgesic and a local anesthetic. Its toxicity is low, and neither tolerance nor habituation has been reported. These actions have prompted its use, with reported success, in various spasmodic conditions of the smooth muscles. Pal recommends it especially in all kinds of gastric and intestinal spasms (also for the diagnosis of pyloric spasm), in biliary colic, and in bronchial spasm. Of more doubtful value is its employment in pertussis, hyperemesis, and vascular spasm — angina pectoris, acute uremia and eclampsia. It is admitted to be inefifective in chronic hypertonus. The local anesthetic action, with vaso- dilatation, has been used against rhino-asthma, and to mitigate the pain of irritant injections. Dosage. — The oral and hypodermic single dose is from 0.03 to 0.08 Gm. (^ to Ws grain); daily dose to 0.5 Gm. (7^ 308 NEW AND NONOFFICIAL REMEDIES grains). Single doses of even 1 Gm. (15 grains) are said to be nontoxic. Papaverine occurs in fine, white rhombic prisms or needles or some- times in scales; it is odorless and tasteless. It is nearly insoluble in cold water; slightly soluble in alcohol, ether, chloroform and ben- zene if cold; somewhat more soluble in these liquids when hot, but deposited by them on cooling, and soluble in warm petroleum ether and in acetone. It melts at 147 C. If about 0.01 Gm. of papaverine is dissolved in 10 cc. of water containing a few drops of diluted hydrochloric acid, and a few drops of potassium ferricyanide solution is added, a lemon yellow precipitate of papaverine ferricyanide should form at once {distinction from other opitun alkaloids). If about 0.001 Gm. of papaverine is dissolved in 0.1 cc. of sulfuric acid containing in each cubic centimeter 1 drop of formaldehyde solution, a colorless or, at most, a faintly yellowish- green solution should be produced. This gradually changes to deep rose and finally becomes brown {distinction from vwrpliine and its esters, which give purple or violet colors). If 0.01 Gm. of papaverine is dissolved in 0.2 cc. of sulfuric acid, the solution should not be colored more deeply than a very faint pink or brown (limit of crypto- pine, thebaine or of other organic impurities). If 0.01 Gm. of papa- verine is dissolved in 10 cc. of water containing a few drops of hydro- chloric acid, a few drops of a saturated aqueous solution of iodic acid added, and the mixture shaken with chloroform, the chloroform layer should not be colored violet {morphine). If from 0.2 to 0.3 Gm. of papaverine is weighed, dissolved in 20 cc. of warm water containing a few drops of diluted hydrochloric acid, the solution cooled, 1 cc. of freshly prepared potassium ferricyanide solution added, the mixture agitated, allowed to stand over night and filtered, the filtrate made alkaline with ammonia water, shaken with several successive portions of ether, the ether solutions combined, washed with water, evaporated, the residue dried at 100 C. and weighed, the weight should not amount to more than 2 per cent of the weight taken (limit of foreign opium alkaloids). PAPAVERINE HYDROCHLORIDE.— For standards see the National Formulary under Papaverine Hydrochloridum. Actions, Uses and Dosage. — See preceding article, Papaverine. Papaverine hydrochloride occurs in a fine white, crystalline powder or in small monoclinic plates or prisms; odorless and having a bitter taste; permanent in the air. It is sparingly soluble in water; soluble in alcohol; very soluble in chloroform and insoluble in ether. An aqueous solution of papaverine hydrochloride has an acid reaction toward litmus paper. If from 0.2 to 0.3 Gm. of papaverine hydrochloride is weighed, dis- solved in 20 cc. of warm water, the solution cooled, a slight excess of ammonia water added and the mixture shaken with three successive portions of 25 cc. each of ether, or a sufficient quantity to complete the extraction, the ether solutions combined, washed with water, evap- orated to dryness, the residue dried to constant weight at 100 C. and weighed, the weight should indicate not less than 88 per cent of papa- verine. The alkaloid obtained by this process should conform to the tests for identity and purity described under Papaverine. Papaverine Hydrochloride-Merck. — A brand of papav- erine hydrochloride-A^ F. Manufactured by Merck & Co., Inc., Rahway, N. J. Papaverine Hydrochloride-Roche. — A brand of papav- erine hydrochloride-A^. F. ^lanufactured by Hoflfmann-LaRoche, Inc., Nutley, N. J. ORGANS OF ANIMALS 309 ORGANS OF ANIMALS The discovery of the importance of internal secretions has led to extensive clinical trials with preparations of the so-called ductless glands, and other tissues which elaborate, or yield on extraction, active principles. Seven of these, the thyroid, the adrenal medulla, the posterior lobe of the pituitary gland, the parathyroid glands, the pancreas (insulin) and liver and stomach (antianemic material) have given decisive therapeutic results. Thyroid in the form of the desiccated gland or as the pure principle thyroxine, epinephrine from the medulla of the adrenal glands, extracts of the posterior pituitary gland, the parathyroid glands, the liver and desiccated stomach are included in the U. S. Pharmacopeia; insulin is described in this book. The other organ products are scarcely beyond the experimental stage from the therapeutic standpoint although physiologically active principles have been obtained from the anterior lobe and pars intermedia of the pituitary gland, the adrenal cortex, the gonads, the placenta and from the urine especially in preg- nancy ; active extracts of thymus and pineal body have also been reported. Many commonly used preparations, most of which are of no demonstrated therapeutic value, are in the form of the powdered dried gland from which the gross fat and connective tissue is removed as completely as possible, and the drying is conducted at a relatively low temperature. The powder (often improperly called an "extract") is frequently compressed into tablets. The Council recommends that the "strength" of these stated in terms of the dried gland. Since, in general, there are no tests for the quality, or even identity, of these powdered products, the physician, unless he can him- self supervise their preparation, is forced to rely on the general reputation of the manufacturer. Further information is available in the Council publication Glandular Physiology and Therapy (American Medical Asso- ciation, 1935). Liver and Stomach Preparations Investigation has demonstrated striking therapeutic effects from the feeding of liver or certain preparations of liver or of a preparation of stomach tissue in pernicious anemia and sprue when the bone marrow is not exhausted; also in certain cases of obscure anemia. Preparations obtained from liver have also been used experi- mentally as a means of controlling essential hypertension and in certain eclamptic conditions. Thus far the Council has accepted only those preparations of liver primarily intended for the treatment of pernicious anemia. Convincing evidence is now at hand that the daily ingestion of from 200 to 400 Gm. of fresh liver will induce and maintain a remission in pernicious anemia. It has also been shown that concentrates may be made from such amounts of liver, but these 310 NEW AND NONOFFICIAL REMEDIES possess usually not more than two thirds of the original activity of the liver from which they are derived. Similar effects can be produced by 30 to 40 Gm. of desiccated stomach and by combinations of stomach tissue and liver. Extracts suitable for parenteral administration may be prepared from 10 to 15 Gm. of liver and will possess a therapeutic effect equal to that of the large amounts of liver given above. Standardization of preparations depends on the reticulocyte response following the uniform daily administration of the product to a patient with pernicious anemia. The test patient should preferably have no complicating infection, diarrhea, marked arteriosclerosis or extensive neurologic changes. The red blood cell count should be between 1,000,000 and 3,000,000 per cubic millimeter and the patient should not be in a spon- taneous or induced remission, nor should transfusion have been performed recently. The patient should not have received potent antianemic material or arsenic within a month. Daily reticulo- cyte counts for one day before and for ten days after the test has been started should be made. During days of marked rise of reticulocytes, two counts a day may be necessary to determine the maximal value. The acceptable standard response is set forth in the accompanying table. Initial Minimum Red Blood Count Reticulocyte Response [illion per Cu. Mm. Per Cent 1.0 30 l.S 18 2.0 12 2.5 7 3.0 4 The figures given have been obtained by the daily oral admin- istration of material derived from 300 to 400 Gm. of liver, or of 30 to 40 Gm. of desiccated stomach, or by the daily parenteral injection of material derived from 10 to 15 Gm. of liver. The test should be conducted by uniform daily administration for ten days of the least amount of material expected to yield the standard reticulocyte response. Should there be no reticulo- cyte response or a lesser response than the required minimum, within the ten-day period, that amount of a preparation of estab- lished potency known to correspond to the foregoing standards should be administered in uniform dosage for ten days. The purpose of this control is to establish the reactivity of the patient to known amounts of active principle. In assaying an orally administered product an orally administered standard should be used, and with a product for parenteral use a paren- terally administered standard should be employed. The principles underlying the determination of potency of autolyzed liver preparations, stomach tissue extracts or combinations of liver and stomach tissue or extracts are the same. In each case the least daily amount of the preparation administered that is neces- sary to produce the standard reticulocyte response within the ORGANS OF ANIMALS 311 ten-day period should be determined. Satisfactory responses to similar tests should be obtained in at least three patients. The Council will require that all preparations designed for use in the treatment of pernicious anemia be manufactured by a satisfactory method and that they be labeled with the amount of the contained material which will produce the standard rise of reticulocytes when assayed in the manner defined. SOLUTIONS FOR ORAL ADMINISTRATION SOLUTION OF LIVER.— Liquid Extract of Liver.— "Contains that soluble fraction of mammalian livers which increases the number of red blood corpuscles in the blood of persons suffering from pernicious anemia, and conforms to the specifications outlined under Standardization of Products for the Treatment of Pernicious Anemia" U. S. P. CHAPPEL LIVER EXTRACT (ORAL).— A solution of a water-soluble fraction extracted from fresh mammalian liver. The daily oral administration of 60 cc. (2 fluid ounces) has been found to produce the standard reticulocyte response as defined by the Council when assayed in cases of pernicious anemia. Actions and Uses. — Chappel liver extract (oral) is used in the treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — From 15 to 90 cc. (4 to 24 fluidrachms) daily. Manufactured by Chappel Bros., Inc., Rockford, III. No U. S. patent or trademark. Chappel liver extract (oral^ is prepared from livers selected from healthy animals, U. S. government inspected and as free as possible from fat. The livers are finely ground while still warm and extracted several times with water. After precipitation of the proteins by heat, the volume of the liquid is reduced in vacuo at low temperature, alcohol added to bring the alcoholic strength to 70 per cent, the pre- cipitate filtered out, and the filtrate again evaporated. The residue is dissolved in a hydro-alcoholic menstruum containing 18 per cent of alcohol with a small quantity of flavoring added. CONCENTRATED LIVER EXTRACT-ARMOUR. — A solution of a water-soluble fraction extracted from fresh mammalian liver. The daily oral administration of 45 cc. (1^ fluid ounces) has been found to produce the standard reticulocyte response as defined by the Council when assayed in cases of pernicious anemia. Actions and Uses. — Concentrated liver extract- Armour is used in the treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — Concentrated liver extract-Armour is administered orally. The average dose is 15 cc. (4 fluidrachms) three times daily, mixed with orange juice or milk. Manufactured by Armour and Company, Chicago. No U. S. patent or trademark. Concentrated liver extract-Armour is made by the process developed by Dr. K. K. Koessler and his co-workers, Drs. M. T. Hanke and 312 NEW AND NONOFFICIAL REMEDIES Siegfried Maurer in the laboratory of the Otho S. A. Sprague Memorial Institute at the University of Chicago. Fresh livers still retaining the animal heat are finely minced and macerated with three volumes of water. The coagulable proteins are removed by heat and the liquid is condensed at low temperature and negative pressure. The resulting extract is treated with hot 85 per cent alcohol under a reflux con- denser and the soluble fraction separated by filtration. The clear filtrate is _ evaporated to dryness in vacuo and the residual extract dissolved in distilled water containing 20 per cent of alcohol. SOLUTION LIVER EXTRACT (LEDERLE) FOR ORAL USE. — A hydro-alcoholic solution of an active prin- ciple of liver extract (Cohn's fraction G). No protocols having been received at the time of going to press, the usual potency statement is not given for this product. Actions and Uses. — Solution liver extract (Lederle) for oral use is used in the treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage— From 20 to 60 cc. (5 to 15 fluidrachms) daily. The maintenance dose is determined individually for each patient. Manufactured by Lederle Laboratories, Inc., Pearl River, N. Y. No U. S. patent or trademark. To prepare solution liver extract (Lederle) for oral use the finely minced livers of edible animals are added to water. The mixture is adjusted to a pn of 5.4 to 5.8, heated to 75 C, held at this tempera- ture for thirty minutes and filtered. The filtrate is concentrated in vacuo to a small volume. By fractional precipitation with alcohol at 4 C. much inactive material is precipitated and discarded. The alco- holic filtrate is concentrated in vacuo and sufficient absolute alcohol added to precipitate the active material. The active material is dis- solved in a hydro-alcoholic menstruum containing in the finished product 20 per cent of alcohol by volume. SOLUTION LIVER EXTRACT- VALENTINE.— A solution of a water-soluble fraction extracted from edible livers of mammalian animals. The daily oral administration of 45 cc. (1^ fluid ounces) (55.5 Gm.) has been found to produce the standard reticulocyte response as defined by the Council when assayed in cases of pernicious anemia. Actions and Uses. — Solution liver extract- Valentine is used in the treatment of pernicious anemia and sprue. Dosage. — Solution liver extract- Valentine is administered orally. Ninety cubic centimeters, or 3 ounces, is the average daily dose ; this is usually divided into three parts and admin- istered at the end of each meal. The daily amount may be reduced to 60 cc, or 2 ounces, when the erythrocyte count reaches 4.5 million per cubic millimeter. If the count tends to increase above this level the quantity may be reduced to 30 cc, or 1 ounce, daily. The maintenance dose should be varied in keeping with the requirements of the individual patient. Manufactured by the Valentine Company, Inc., Richmond, Va. No U. S. patent. U. S. trademark 298,963. To prepare solution liver extract-Valentine, livers from edible animals are ground directly into water. The mixture is heated to approximately 90 C. to coagulate protein and to inactivate liver enzymes. The coagu- lated protein is then removed by filtration. Approximately 9 per cent of glycerin and 0.2 per cent of sodium chloride are added to the finished product. ORGANS OF ANIMALS 313 POWDERS FOR ORAL ADMINISTRATION EXTRACT OF LIVER.— Dry Liver Extract.— "Contains that soluble fraction of mammalian livers which increases the number of red blood corpuscles in the blood of persons suffering from pernicious anemia. This fraction, which has been dried, conforms to the specifications outlined under Standardisation of Products for the Treatment of Pernicious Anemia" U. S. P, AUTOLYZED LIVER CONCENTRATE-SQUIBB. — A mixture containing autolyzed liver concentrate 95 per cent, monosodium glutamate, 5 per cent, with a small amount of extract of onion and black pepper as flavoring. The daily oral administration of 33.4 to 44.5 Gm, (6 to 8 teaspoonfuls) has been found to produce the standard reticulocyte response as defined by the Council when assayed in cases of pernicious anemia. Actions and Uses. — Autolyzed liver concentrate- Squibb is pro- posed for use in the treatment of pernicious anemia. See preced- ing article. Liver and Stomach Preparations. Dosage. — Six to eight teaspoonfuls in divided doses daily for a period of ten days ; thereafter a maintenance dose of three to four teaspoonfuls daily is usually sufficient. Manufactured by E. R. Squibb &• Sons, New York, by license of the University of Pittsburgh Medical School. U. S. patent No. 2,032,544 (March 3, 1936; expires 1953). No U. S. trademark. Fresh edible livers which have been chilled immediately on removal from the body, are ground and mixed with fiftieth-normal hydrochloric acid. Sufficient chloroform is added to act as a preservative and prevent bacterial growth. The mixture is incubated at 37 C. and autol- ysis allowed to proceed from five to ten days. The solution is then filtered to remove any undigested material; the filtrate which contains the active material is desiccated at a lower temperature in vacuo, and the resulting mass ground to a fine powder. Five per cent of mono- sodium glutamate is added together with a small amount of extract ot onion and black pepper as flavoring. LIVER EXTRACT-LEDERLE.— A concentrated, water- soluble, nitrogenous, nonprotein fraction obtained from fresh mammalian liver. No protocols having been received at the time of going to press, the usual potency statement is not given for this product. Actions and Uses. — Liver extract-Lederle is proposed for use in the treatment of pernicious anemia. See preceding article. Liver and Stomach Preparations. Dosage. — Liver extract-Lederle is administered orally. The optimum daily dose is the contents of from six to eight vials ; for the average case, an initial daily dose of the contents of six vials is sufficient. Manufactured by Lederle Laboratories, Inc., Pearl River, N. Y. No U. S. patent or trademark. To prepare liver extract-Lederle, the finely minced livers of edible animals are added to water. The mixture is adjusted to a pn of from 5.4 to 5.8, heated to 75 C. to coagulate the protein, held to this temperature for thirty minutes, and filtered. The filtrate is concen- trated in vacuo to small bulk, and enough 95 per cent alcohol is added 314 NEW AND NONOFFICIAL REMEDIES so that the final mixture contains 65 per cent of alcohol by volume. The precipitate is discarded and the alcoholic filtrate concentrated in vacuo, sufficient absolute alcohol being added to precipitate the active material, which is subsequently dried in vacuo and granulated. It is soluble in water; insoluble in alcohol, acetone, or ether. LIVER EXTRACT-LILLY. — A water-soluble. nitrog= enous, nonprotein fraction obtained from fresh mammalian liver in powdered form. No protocols having been received at the time of going to press, the usual potency statement is not given for this product. Actions and Uses. — Liver extract-Lilly is used in the treat- ment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — Liver extract-Lilly is administered orally. The initial daily dose for the average uncomplicated case being from 12.6 to 25.2 Gm. (3 to 6 level teaspoonfuls or the contents of 3 to 6 vials). Manufactured by Eli Lilly & Company, Indianapolis, No U. S. patent. U. S. trademark 243,147. Liver Extract-Lilly, 110 Gm. bottle. Liver Extract-Lilly Vials: Each vial contains 4.2 Gm. of powdered extract. To prepare liver extract-Lilly, livers from edible animals are ground directly into water, and the mixture adjusted to the iso-electric point (approximately pu 5 to pn 6). The mixture is then heated to coagulate protein (approximately 80 C.) ; stirred for thirty minutes, and filtered. The filtrate is reduced in vacuum to a small volume and enough 95 per cent alcohol added to produce a concentration of 70 per cent. The precipitate which is _ formed is discarded and the filtrate reduced to a small volume; it is added to absolute alcohol and the precipitate separated, dried in vacuum and powdered. Liver extract-Lilly is a yellow powder having a not unpleasant taste, almost entirely soluble in water. It is precipitated from the aqueous solution by alcohol and acetone. It is insoluble in ether. LIVER EXTRACT-PARKE, DAVIS & CO.— A light brown granular powder representing a water-soluble fraction of mammalian liver, which contains the substance effective in the treatment of pernicious anemia. The daily oral adminis- tration of 18 to 21 Gm. (the contents of six vials) has been found to produce the standard reticulocyte response as defined by the Council when assayed in cases of pernicious anemia. Actions crnd Uses. — Liver extract-Parke, Davis & Co. is used in the treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — The maximum daily dose needed to induce remis- sion in severe relapse of pernicious anemia is the contents of from four to six vials (12 to 21 Gm.), to be continued within this range until the red blood cells and hemoglobin have reached normal. The contents of from two to four vials daily con- stitute the maintenance dose. Manufactured by Parke, Davis & Co., Detroit. No U- S. patent or trademark. ORGANS OF ANIMALS 315 J'ials Liver Extract-Parke, Davis & Co. : Each vial contains from 3 to 3.5 Gm. of powdered extract. Fresh livers from edible animals are finely minced and macerated for one-half hour with cold water having a pa of 5. The mixture is then heated at about 85 C. and filtered. The filtrate is reduced to a small volume at a low temperature, in vacuo. Alcohol is added until a concentration of 70 per cent has been reached; the mixture is again filtered, evaporated, dried in vacuo and powdered. No product is released for use until approved by the Thomas Henry Simpson Memorial Institute, University of Michigan, Ann Arbor, Mich. LIVER MEAL. — A mixture containing desiccated beef liver 81 per cent, malted milk 18 per cent, and powdered cinnamon 1 per cent. Actions and Uses. — Liver meal is prepared to meet the need of a concentrated liver diet in a form that is palatable and convenient. Dosage. — For children, one heaping teaspoonful three times daily ; for adults, two heaping teaspoonfuls three times daily. Liver meal may be added to milk, soups, cereals or fruit juices but should not be cooked or boiled. Manufactured by the Livermeal Corporation, Hoboken, N. J. No U. S. patent or trademark. To prepare liver meal, fresh beef liver is ground and then coagulated in air-tight kettles at a temperature of 82 C. The liver is dehydrated in vacuo and powdered. The malted milk and powdered cinnamon are then added and thoroughly mixed. The manufacture is so regulated that no batch is more than thirty days old when shipped. The malted milk used complies with the government standard and has approxi- mately the following composition: carbohydrates, 71.22 per cent; pro- teins, 14.48 per cent; fat, 8.15 per cent; ash, 3.43 per cent, and water, 2.72 per cent. Liver meal is a light brown powder having a slight odor and taste of liver. EXTRALIN. — A liver-stomach concentrate resulting from the interaction of a mammalian concentrated liver extract con- taining the Cohn fraction D and stomach tissue material. No protocols having been received at the time of going to press, the usual potency statement is not given for this product. Actions and Uses. — Extralin is proposed for use in the oral treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — For cases of pernicious anemia in relapse, an initial dosage of 2 Gm. (four pulvules) three times daily is suggested ; 1.5 Gm. (three pulvules) three times daily constitutes an ade- quate maintenance dose for most cases. The amount necessary for maintenance varies with different individuals and can be determined only after repeated examinations. Manufactured by Eli Lilly & Co., Indianapolis, Ind. U. S. patent 1,894,247 (Jan. 10, 1933; expires 1950). U. S. trademark 290,233. 316 NEW AND NONOFFICIAL REMEDIES Pulvules Extralin, 0.5 Gm. : The content of each pulvule is equiva- lent in antianemic potency to approximately 20 Gm. of fresh liver. An extract containing the Cohn fraction D is prepared by grinding mammalian livers into water, adjusting the mixture to the iso-electric point (approximately pn 5 to pu 6), and heating to about 80 C. to coagulate protein; this is stirred for thirty minutes and filtered; the filtrate is reduced under vacuum to small volume. This extract is then admixed with finely minced fresh hog stomachs or fresh hog stomach linings. The hydrogen ion concentration is adjusted to approximately pn and the mixture allowed to interact or digest for about two hours at 37.5 C. It is then spread out in a thin layer on pans and dried under vacuum. The dried product is removed from the drier and ground, then extracted with petroleum ether to remove fat. The defatted material is then extracted with water and filtered, and the filtrate concentrated under vacuum to a thick syrup. This is dried under vacuum and ground to the proper fineness. The proportions used are such that there is represented in the finished product two to four parts of original liver to one part of original stomach tissue material. STOMACH. — Dried Stomach. — "The dried and powdered defatted wall of the stomach of the hog, Sus scrofa var. Domes- ticus Gray (Fam, Suidae). It contains that antianemic factor which causes an increase in the number of red blood corpuscles in the blood of persons suffering from pernicious anemia. This substance conforms to the specifications outlined under Stan- dardization of Products for the Treatment of Pernicious Anemia." U. S. P. EXTRALIN (See under Liver). VENTRICULIN.— Desiccated, defatted, hog stomach. The daily oral administration of 30 Gm. has been found to produce the standard reticulocyte response as defined by the Council when assayed in cases of pernicious anemia. Actions and Uses. — Ventriculin is proposed for use in the treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — From 20 to 30 Gm. is administered daily, suspended in a half glassful of water or fruit juice. When the red blood cell count has reached a satisfactory level, 10 Gm. is usually sufficient as a maintenance dose. In severe relapses a dosage of from 20 to 30 Gm. is indicated. Manufactured by Parke, Davis & Co., Detroit. U. S'. jiatent applied for. U. S. trademark number 270,811. Ventriculin, 10 Gm. Vials. Ventriculin, 100 Gm. Bottle. Ventriculin, 500 Gm. Bottle. Ventriculin is a granular substance, practically insoluble in water and having a faint odor and slight taste. To prepare ventriculin, fresh, whole stomachs from healthy hogs are freed from extraneous fat, ground and dried in a vacuum at a tem- perature not exceeding 65 C. The dried material is then defatted by extraction with purified benzin. The defatted material is dried with- out further application of heat, ground and milled to coarse powder. No product is released for use until approved by the Simpson Memorial Institute, University of Michigan, Ann Arbor, Mich. ORGANS OF ANIMALS 317 SOLUTIONS FOR PARENTERAL ADMINISTRATION PURIFIED SOLUTION OF LIVER.— Parenteral Solu- tion of Liver. — "Contains that soluble fraction of mammalian livers which increases the number of red blood corpuscles in the blood of persons suffering from pernicious anemia, and conforms to the specifications outlined under Staiidardicatioii of Products for the Treatment of Pernicious Anemia." U. S. P. CHAPPEL LIVER EXTRACT (SUBCUTANEOUS). — A sterile aqueous solution, containing the nitrogenous, non- protein fraction G of Cohn et al. obtained from fresh mammalian liver, preserved with cresol 0.4 per cent. The daily parenteral administration of 2.5 cc. has been found to produce the stand- ard reticulocyte response as defined by the Council when assayed in cases of pernicious anemia. Actions and Uses. — Chappel liver extract (subcutaneous) is proposed for subcutaneous or intramuscular injection in the treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — Two cc. daily; the maintenance dose is 2 cc. at intervals of from ten to twenty days. Manufactured by Chappel Bros., Inc., Rockford, 111. No U. S. patent or trademark. Ampoules Chappel Liver Extract (Subcutaneous) 2.5 cc. To prepare Chappel liver extract (subcutaneous), finely ground equine livers are extracted several times \yith water. After precipita- tion of the proteins by heat, the liquid is concentrated in vacuo at low temperature, alcohol added to bring the alcoholic strength to 70 per cent, the precipitate filtered out, and the filtrate again evapo- rated. Sufficient absolute alcohol is then added to bring the alcoholic strength of the liquid up to 95 per cent. The precipitate is then dissolved in water and the reaction of the solution adjusted to pH 7.2. Cresol 0.4 per cent is added as preservative and the solution is then filtered. ONE CC. CONCENTRATED SOLUTION LIVER EXTRACT PARENTERAL-LEDERLE.— A sterile, aque- ous solution, containing the nitrogenous nonprotein fraction G of Cohn et al. obtained from fresh mammalian liver, preserved with 0.5 per cent of phenol. No protocols having been received at the time of going to press, the usual potency statement is not given for this product. Actions and Uses. — Concentrated solution liver extract paren- teral-Lederle is proposed for intramuscular injection in the treatment of pernicious anemia. See preceding article. Liver and Stomach Preparations. Dosage. — To insure optimum dosage for cases of pernicious anemia in relapse it is advisable to make an injection of 1 cc. each day for three or four successive days. In a series of cases in which remissions have been thus initiated by the use of con- centrated solution liver extract parenteral-Lederle there is evi- dence that injections of 1 cc. every two weeks provide sufficient active material to complete the remission and maintain a satis- 318 NEW AND NONOFFICIAL REMEDIES factory blood picture. In complicated cases and those with extensive neurologic involvement, the optimum dosage may be much larger and must be determined for each patient. Manufactured by the Lederle Laboratories, Inc., Pearl River, N. Y. Vials Concentrated Solution Liver Extract Parenteral-Lederle, 1 cc. Concentrated solution liver extract parenteral-Lederle is prepared as follows: A mixture of finely ground liver and water is acidified to the isoelectric point, pn 5.0-5.4. After partial coagulation of the liver proteins is effected by heating to 75-85 C. the pulp is separated by filtration, centrifugation or pressing and the aqueous filtrate is concentrated in vacuo to the consistency of a thin syrup. By careful fractional precipitation with large volumes of alcohol at low tem- peratures (4 C.) much inactive material (proteins) is precipitated and subsequently discarded. The alcoholic filtrate is concentrated in vacuo and sufficient alcohol added to precipitate the active material (fraction G) of Cohn et al. (Proceedings of the American Society of Biological Chemistry, /. Biol. Chem. 74:lxix [July] 1927). The washed precipitate, generally known as "Cohn's fraction G," com- monly obtained as a hygroscopic, brownish powder, in addition to the active antianemic factor, contains much inert matter. In order to obtain a concentrate of the active factor as free as possible from inert substances, the solution containing the fraction G of Cohn is treated with a special activated carbon. Subsequently the material is concentrated in vacuo. The solution is then sterilized and 0.5 per cent of phenol added as a preservative. THREE CC. CONCENTRATED SOLUTION LIVER EXTRACT PARENTERAL-LEDERLE. — A sterile, aqueous solution, containing the nitrogenous nonprotein fraction G of Cohn et al. obtained from fresh mammalian liver, preserved with 0.5 per cent phenol. No protocols having been received at the time of going to press, the usual potency statement is not given for this product. Actions and Uses. — Lederle solution liver extract parenteral refined and concentrated is proposed for intramuscular injection in the treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — To insure optimum dosage for cases of pernicious anemia in relapse it is advisable to make an injection of 3 cc. each day for three or four successive days. In a series of cases in which remissions have been thus initiated by the use of Lederle solution liver extract parenteral refined and concen- trated there is evidence that weekly injections of 3 cc. provide sufficient active material to complete the remission and maintain a satisfactory blood picture. In complicated cases and those with extensive neurologic involvement, the optimum dosage may be much larger and must be determined for each patient. Manufactured by the Lederle Laboratories, Inc., Pearl River, N. Y. yials Lederle Solution Liver Extract Parenteral Refined and Concen- trated, 3 cc. To prepare Lederle solution liver extract parenteral refined and con- centrated, the finely minced livers of edible animals are added to water. The mixture is adjusted to a pu of 5.4 to 5.8, heated to 75 C, held at this temperature for thirty minutes and filtered. The filtrate is concentrated in vacuo to a relatively small volume. By fractional pre- cipitation with large volumes of alcohol at low temperatures (4 C.) much inactive material (proteins) is precipitated and subsequently dis- carded. The alcoholic filtrate is concentrated in vacuo and sufficient ORGANS OF ANIMALS 319 absolute alcohol added to precipitate the active material (fraction G) of Cohn et al. (Proceedings of the American Society of Biological Chemistry, J. Biol. Chetn. 74: Ixix, 1927). The active material is dissolved in water, the reaction of the solution is adjusted to />h 6.6 to 6.8, and after calculation of the final volume (from weight of liver used), 0.5 per cent of phenol is added. The solution is subsequently passed through a Berkefeld filter and, after regular sterility tests, is filled into vials. LIVER EXTRACT (INTRAMUSCULAR)-PARKE, DAVIS & CO. — A sterile aqueous solution, containing the nitrogenous nonprotein fraction G of Cohn et al. obtained from fresh mammalian liver. The daily parenteral administration of 2 cc. has been found to produce the standard reticulocyte response as defined by the Council when assayed in cases of pernicious anemia. Actions and Uses. — Liver extract (intramuscular) -Parke, Davis & Co. is used in the treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — Two cc. daily is usually sufficient to induce remis- sion in severe relapse of pernicious anemia. This dosage is repeated until the red blood cells and hemoglobin have reached normal. The maintenance dose is 2 cc. every two or three days. Manufactured by Parke, Davis & Co., Detroit. No U. S. patent or trademark. Glaseptic Ampoules Solution Liver Extract-P. D. & Co. (Intramus- cular) 2 cc. To prepare liver extract (intramuscular) Parke, Davis & Co., liver extract-Parke, Davis & Co. is dissolved in distilled water at a con- centration of about 3 Gm. for each 20 cc. of solution. The solution is treated with a silicate of aluminum, sodium and calcium to eliminate toxic nitrogenous substances, filtered through Berkefeld filters and filled into ampules. Tlje ampules are sterilized and a representative sample of each lot tested for sterility. No product is released for use until approved by the Thomas Henry Simpson Memorial Institute, Univer- sity of Michigan, Ann Arbor, Mich. SOLUTION LIVER EXTRACT CONCENTRATED- LILLY. — A sterile aqueous solution containing the nitrogenous nonprotein fraction G of Cohn, preserved with 0.5 per cent phenol. No protocols having been received at the time of going to press, the usual potency statement is not given for this product. Actions and Uses. — Solution liver extract concentrated-Lilly is proposed for intramuscular injection in the treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — For the average patient in relapse, 3 cc. is given daily for three successive days, then 3 cc. is given at weekly intervals until sufficient time has elapsed in which to observe the response. Thereafter, either the volume of the dose or the time interval between doses is adjusted according to the indi- vidual patient's needs. Manufactured by Eli Lilly & Co., Indianapolis. U. S. patent No. 1,914,338. No U. S. trademark. 320 NEW AND NONOFFICIAL REMEDIES Ampoules Solution Liver Extract Concentrated-Lilly, 10 cc. To prepare solution liver extract concentrated-Lilly, livers from edible animals are ground directly into water and the mixture adjusted to the iso-electric point (approximately pn 5 to 6). The mixture is then heated to coagulate protein (approximately 80 C), stirred for thirty minutes and filtered. The filtrate is reduced in vacuum to a small volume and enough alcohol added to produce a concentration of 70 per cent. The 70 per cent alcohol solution is then chilled, and the resulting precipitate discarded. The filtrate is reduced in vacuum to a small volume, added to several volumes of alcohol, and the pre- cipitate separated therefrom. The precipitate is dissolved in water and filtered. The solution is sterilized by boiling and then passed through Berkefeld filters; 0.5 per cent phenol is added as a preservative. SOLUTION LIVER EXTRACT-LILLY. — A sterile aqueous solution of liver extract-Lilly, preserved with 0.3 per cent of cresol. No protocols having been received at the time of going to press, the usual potency statement is not given for this product. Actions and Uses. — Solution liver extract-Lilly is proposed for intramuscular injection in the treatment of pernicious anemia. See preceding article, Liver and Stomach Preparations. Dosage. — Determined by the condition of the patient. Daily intramuscular injection of 2 cc. has been followed by maximal reticulocyte count. The maintenance dose varies with the individual patient. Manufactured by Eli Lilly & Co., Indianapolis, Ind. No. U. S. patent. U. S. trademark 243,147. Ampoules Solution Liver Extract-Lilly, 10 cc. To prepare solution liver extract-Lilly, livers from edible animals are ground directly into waterj and the mixture adjusted to the iso- electric point (approximately pn 5 to pH 6). The mixture is then heated to coagulate protein (approximately 80 C), stirred for thirty minutes, and filtered. The filtrate is reduced in vacuum to a small volume and enough 95 per cent alcohol added to produce a concentra- tion of 70 per cent. The precipitate that is formed is discarded and the filtrate reduced to a small volume; it is added to alcohol and the precipitate separated, dried in vacuum, dissolved in water; 0.3 per cent of cresol is added, and the mixture is filtered, sterilized and filled into ampules. Ovary The ovaries produce internal secretions which are necessary for the proper functioning of the uterus, in particular, for the production of cyclic growth processes of this organ and for the development of the decidua ; in addition these internal secre- tions determine cyclic changes in the vagina and cervix and influence the growth of the mammary gland. The ovary may perhaps also exert a certain influence on metabolism and appar- ently also on the nervous system. However, these latter effects are not well defined at the present time. There is good reason for assuming that in addition to intrinsic factors situated in the ovary itself, hormones given off by the anterior pituitary regu- late the growth of the follicles, ovulation, and corpus luteum formation. ORGANS OF ANIMALS 321 Various preparations of the ovary of animals have been used in the treatment of conditions beHeved to be due to ovarian dysfunction, on the assumption that the preparations contain the active principles or hormones of the ovary. Preparations of the whole ovary, corpus luteum, liquor folliculi and ovarian residue have been employed. Rational as ovarian therapy may theoretically appear to be in some conditions, the actual results are rarely striking, and often nil to the careful observer. It is altogether probable that the activity which may be pre- sented by the fresh gland is not contained in a finished desiccated product, or else, when given by mouth, it is destroyed by the digestive juices; extensive clinical experience has failed to establish the value of desiccated preparations administered orally. Favorable reports have often concerned cases in which ovarian products were given together with preparations of the thyroid gland, the activity of which is not appreciably destroyed in the digestive tract. The so-called follicular hormone has been shown to induce estrus in mature animals and sexual maturity in immature animals, either normal or ovariectomized. It is also responsible for the appearance of certain secondary sex characteristics in some animals and is believed to play an important role in mammary development. Knowledge concerning certain possible functions exercised in menstruation and pregnancy has not progressed beyond the conjectural stage but it is suggested that this hormone may play a part in premenstrual proliferation of the uterine mucosa and in development of the mammary gland in pregnancy. In certain mammals (women and mares) during pregnancy estrogenic substances also occur in large amounts in the blood, urine, placenta, amniotic fluid, umbilical cord and fetal blood. Numerous assayed and active prepara- tions, closely related chemically, are available for injection in pure or partially purified form, their source in most cases being pregnancy urine or placenta. Their clinical field of usefulness has not yet been adequately defined although the most favorable results have been in the relief of menopausal symptoms and in the treatment of gonorrheal vulvovaginitis in children. The Council has recognized the nonproprietary name Theelin for the crystalline (ketohydroxy) estrogenic hormone as described by Doisy and the nonproprietary name Theelol for the crystal- line (trihydroxy) estrogenic hormone as described by Doisy. A crystalline substance, believed to be dihydrotheelin (estradiol), recently isolated from the follicular fluid of hog ovaries, is definitely more actively estrogenic by the usual methods of assay. The corpus luteum produces those proliferative changes in the uterus which precede and make possible the nidation of the ovum and apparently sensitizes the uterus so that it responds to the embryo by decidua formation. It is also believed to be concerned with premenstrual uterine changes, and may cause inhibition of ovulation. 322 NEW AND NONOFFICIAL REMEDIES The active principle of the corpus luteum, progesterone, has been shown to be closely related chemically to estrogenic and androgenic substances. On injection into animals it produces effects in keeping with the above functions and also has been shown to render the uterus in vivo temporarily quiescent and to desensitize it in vitro to the action of the oxytocic principle of the posterior pituitary. Extracts of corpus luteum and progesterone are inactive when given by mouth. Their clinical value is still in the experimental stage but preliminary results have suggested that they may be useful in certain cases of habitual or threatened abortion and also in certain cases of menorrhagia and metrorrhagia. At present no preparation of corpus luteum is accepted by the Council. Pancreas The pancreas is a gland having, in general, two functions : (1) It secretes into the intestine a digestive juice containing the enzymes trypsin, lipase and amylase; (2) it secretes into the blood a hormone, insulin, which regulates the process of carbo- hydrate metabolism. (For description of insulin, see under Insulin.) When insulin secretion is deficient, or possibly when there is an overproduction of sugar due to other causes, the diabetes develops, in which disease the percentage of sugar increases in the blood (hyperglycemia) so that sugar overflows into the urine (glycosuria). The hyperglycemia is associated with a breakdown of the first and last stages in the metabolism of sugar, as revealed, respectively, by failure of glycogen to be deposited in the liver and by failure of the respiratory quotient to become increased when carbohydrate food is ingested. The depression in carbohydrate metabolism impairs that of fats, so that ketone substances (acetone, acetoacetic and oxybutyric acids) appear, producing acidosis and, later, coma. Insulin, if administered subcutaneously, intravenously, or intra- peritoneally, causes a fall in the percentage of sugar in the blood. The exact mode of action is not definitely known but experimental evidence suggests that besides increased oxidation of sugar, increased storage as glycogen in the liver and possibly in the muscles is a factor in the result. When the percentage of blood sugar falls below the kidney threshold in the diabetic patient, sugar disappears from the urine. If an overdose of insulin is given, the blood sugar falls to a subnormal level, and characteristic symptoms are observed. The level at which these symptoms occur depends not only on the extent but also on the rate of fall. If the blood sugar has been persistently high and is rapidly reduced, hypoglycemic symptoms may appear at a much higher level of blood sugar than when the fall is slower and more gradual. These symptoms are due to the diminished sugar in the blood, as shown by the fact that they are relieved by the replacement of the sugar by oral or intravenous admin- istration. ORGANS OF ANIMALS 323 Clinical assays conducted on patients with uncomplicated diabetes on certain standard dietary regimens reveal that one insulin unit will promote the metabolism of approximately 1.5 Gm. of dextrose. The physician may, therefore, gage his insulin dose with some precision. To do so, he must know how much dextrose the patient will derive from his food and metabolism, and how much insulin the patient himself can provide from his insulin-making tissues. The latter may be determined by measuring the patient's ability to utilize carbohydrate without extra insulin. In any case, insulin injections must be made at regular intervals and must be supplemented by accurately weighed diets of known composition. When properly employed, insulin is a specific in the treat- ment of diabetic coma and acidosis. It is of pronounced value in the management of diabetic patients undergoing surgery and of those with complicating infectious diseases. It makes pos- sible freedom from glycosuria and good mental and physical vigor for patients with severe diabetes. There is as yet no positive evidence that treatment with insulin will arrest the diabetic process by restoring the patient's antidiabetic function. In the severer cases, the evidence now available is against such an assumption. In the milder cases in which insulin has been used, the evidence is difficult of inter- pretation because such patients may show very marked improve- ment in their ability to utilize carbohydrate on dietary regulation and exercise alone. Oral Administration of Pancreatic Preparations. — In diabetes, reliance on the oral administration of the pancreatic prepara- tions thus far prepared has no justification and such prac- tice merits the most vigorous condemnation. Many reputed antidiabetic pancreatic preparations are on the market with claims that they are effective if taken by mouth. The most widely heralded of them have been subjected to the scrutiny of clinical tests controlled with simultaneous laboratory inves- tigation. None of these thus tested has shown any effect on blood sugar or glycosuria. Completely negative results were obtained when these preparations were given in the doses rec- ommended by their exploiters as well as in doses twenty times as large. The claim that such preparations exert, in some mysterious manner, a rejuvenating or stimulating action on the diseased pancreas is based on uncontrolled clinical observation. INSULIN. — An aqueous solution of an active principle from pancreas which afifects sugar metabolism. The strength of insulin is expressed in "units." The unit is equivalent to 0.125 mg. of the international standard preparation of dry insulin hydrochloride prepared by the Medical Council of Great Britain. One mg. of this standard preparation contains eight insulin units, as provisionally defined by the Insulin Com- mittee of the University of Toronto. 324 NEW AND NONOFFICIAL REMEDIES Actions and Uses. — Insulin lowers the blood sugar in nor- mal rabbits causing characteristic symptoms when a low level is reached, which symptoms are overcome by the administra- tion of dextrose. It prevents the hyperglycemia due to piqure, asphyxia and epinephrine. It increases the sugar consumption of the isolated mammalian heart. It causes glycogen to be deposited in the liver of diabetic animals fed with carbohy- drates, and raises the respiratory quotient of siich animals. It affects the metabolism of fat in diabetic animals and causes the acetone bodies to disappear from the urine. It has been demonstrated that the administration of insulin to diabetic dogs and to man in severe cases of diabetes mellitus restores tem- porarily to the body the impaired ability to oxidize carbo- hydrate, and that glycogen is again stored in the liver. If a suitable dose of insulin is administered at suitable intervals to a person suffering from diabetes mellitus, the blood sugar is maintained at a normal level and the urine remains free of sugar ; fat is also burned and as a result, ketone bodies do not appear in the urine and diabetic acidosis and coma are prevented. The administration of insulin is indicated in cases of diabetes mellitus which cannot be controlled at a satisfactory level by dietetic treatment. In such cases, with proper regulation of the diet, insulin should be administered in such amounts as to prevent glycosuria and a too great hyperglycemia. In some cases the dosage of insulin may be gradually decreased as the body power of utilizing carbohydrate returns toward normal. Overdosage of insulin is followed by the development of serious symptoms which demand immediate treatment. The patient complains of weakness and fatigue and a feeling of nervousness or tremulousness. This is followed by profuse sweating, which is the most characteristic sign of overdosage. There is sometimes pallor or flushing. In the more severe forms there is acute distress with mental disturbances and even unconsciousness. These symptoms are relieved by the administration of some form of soluble carbohydrate, such as orange juice, by mouth or stomach tube, or, if the patient is comatose, by the intravenous injection of from 5 to 20 grams of pure dextrose in a 5 to 50 per cent sterile solution. Although symptoms of hypoglycemia usually develop gradually, the onset in occasional cases may be sudden. In view of this, ambulant patients should be instructed to carry, for immediate use, soluble carbohydrate in the form of powdered dextrose or an orange. Physicians treating patients with insulin should be impressed with the necessity of having adequate supplies of sterile solution of dextrose at hand. In case of emergency when sterile solution of dextrose is not available, a subcutaneous injection of 0.3 cc. to 0.6 cc. of 1 in 1,000 solution of epinephrine may be employed, but this must always be followed by carbo- hydrates by mouth. The injection of epinephrine must be employed carefully as its action depends on the presence of ORGANS OF ANIMALS 325 glycogen, of which there is usually very little in the diabetic organism. Epinephrine should never be employed when the hypoglycemia follows excessive exercise, vomiting or the omission of meals. Insulin has been used in the treatment of non-diabetic mal- nutrition with reported increase in appetite and gain in weight. Care is necessary in avoiding symptoms of hypoglycemia. Dosage. — Insulin is administered by injection into the loose subcutaneous tissue of the body, usually thirty minutes before meals. There is no average dose of insulin for diabetics ; each case must be studied individually. Except when com- plications occur insulin is not indicated when a patient has adequate dextrose tolerance to provide him with a diet suf- ficient for light work. The dose depends upon the amount of dextrose in such a diet as he is unable to metabolize; i. e., the total dextrose minus the dextrose excretion. A convenient formula Average grams of d-glucose excreted cr • ^ -j. c • i- is : — T-r^ = sufficient units of insulin to render most patients aglycosuric. Usually the daily dose is administered in two equal portions, one before breakfast and the other before supper. The carbohydrate of the diet should be distributed between the three meals. With large daily dosage (40 units or more) insulin may be injected before each meal ; less carbohydrate should be given at breakfast than at the other two meals. When the patient becomes aglycosuric the diet can usually be increased. Sufficient insulin should be used to keep the fasting blood sugar normal, but hypogly- cemia should be avoided. If patients are not under close observation, half the estimated dose may be used and the dose gradually increased until therapeutic results are obtained. Complications, such as infections, may reduce the dextrose tolerance, thus necessitating an increase of insulin dosage. In cases of coma or severe acidosis an initial dose of 30-60 units may be given (in coma one-half the amount intravenously and one-half subcutaneously) followed at J^ to 3 hour intervals by doses of 20 units or more subcutaneously. Some physicians administer 1 Gm. of dextrose for each unit of insulin used. The patient should never become hypoglycemic. Examine the urine hourly for dextrose. If urine becomes sugar free more dextrose must be given. More than 150 units of insulin in twelve hours is rarely needed. Young children with diabetes of recent onset usually require smaller doses and seldom more than 80 units in the first 12 hours. In a small number of cases of diabetes mellitus, insulin can be discontinued, particularly with patients who receive it because of an exacerbation caused by complications, and where diabetes is of recent onset (though perhaps the latter should receive it intermittently as a prophylactic against increasing severity). Dosage of insulin should always be expressed in units rather than in cubic centimeters or minims. The volume of a dose of insulin containing a certain number of units will vary with the 326 NEW AND NONOFFICIAL REMEDIES strength of the solution which is employed. In general it is advisable to keep the volume per injection at from ^ to ^ cc, choosing the strength of insulin v^hich will give the required number of units in this volume or less. The animals used as test subjects and controls are rabbits, unselected as to sex, breed or color, free of any visible sign of infection, and weighing from 1.8 Kg. to 2,2 Kg. Each animal is used once each week as long as it remains suitable in all respects for use, particularly as regards weight. A record of each animal's reaction toward insulin is kept, in order that those showing marked irregularities on more than one occasion may be discarded. Test animals are kept on a diet of hay and oats, carrots being allowed once each week with the first post- assay meal. All new rabbits are placed on this diet for two weeks prior to being first used. Twenty-four hours before rabbits are to be used, all food is removed from their cages, water being allowed to remain. In assaying a sample of insulin the approximate potency of which is unknown, a rough indication of its potency is first obtained by inoculat- ing a number of animals (say, eighteen) with a widely varying number of doses per 2 Kg. body weight (say, six) and rioting the lowest dose which produces convulsions in the majority of animals given that dose. This so-called "convulsant dose" is then considered as about 3 units. For the determinative assay, eighteen rabbits are used each day. Each of these rabbits is weighed and a normal blood sample is taken from it Then three doses of the insulin sample under assay, diluted with acid water ipn 2.5) so that there are presumably 2.5 units in each cc. of solution, are injected subcutaneously into three equal groups of three animals — 2.5 units, 2.0 units and 1.5 units per 2 Kg. body weight being giveri to each animal of the first, second and third groups, respectively. Similarly, three doses of the International Insulin Stand- ard, diluted with acid water (/>h 2.5) so that there are 2.5 units in each cc. of solution, are injected into three equal groups of three ani- mals — 2.5 units, 2.0 units and 1.5 units per 2 Kg. of body weight being given to each animal of the first, second and third of these groups, respectively. At intervals of one and one-half, three and five hours after injection, a sample of blood is withdrawn from each animal. The samples of each bleeding are pooled in equal quantities and the sugar content of these and of the normal blood samples is determined by a suitable method, such as that of Shaffer and Hartrnann (/. Biol. Chem. 45: 365, 1920). Calculations are then made, using the follow- ing equation: a w Units per cc. = — x — x 1.5 where ^ . ? . a = percentage of blood sugar before injection minus the averages of the percentages of blood-sugar found in the samples taken one and one-half, three and five hours after injection, b = percentage of blood sugar before injection minus 0.045 per cent, w = weight of rabbit in kilograms, c = number of cc. of the original (undiluted) insulin injected. For the sample under assay on the one hand, and for that used as a standard (a solution standardized upon the International Insulin Stand- ard) on the other, the averages of the results arising out of the above equation on the first day are compared, and the dilution of the unknown sample is then adjusted from day to day until the two averages become practically identical and remain so for at least three days of confirmatory testing. The potency of the sample under assay may then be arrived at by a simple arithmetical calculation. The doses used in the Insulin Committee Laboratory ordinarily occa- sion convulsions in about 20 to 25 per cent of the anirnais given injec- tions. These may be readily antidoted by an injection of dextrose either intravenously or subcutaneously; but this course should be followed only where an animal is lost to a test through failure to bleed, or where death due to respiratory failure is imminent. U. S. patents 1,469,994 (Oct. 9, 1923; expires 1940), 1,470,024 (Oct. 9, 1923; expires 1940) and 1,520,673 (Dec. 23, 1924; expires 1941). Canadian patent 234,336 and 234,337. U. S. trademark 179,174. Cana- dian trademark 31,646. ORGANS OF ANIMALS 327 Insulin-Mulford. — A brand of insulin. Manufactured by Sharpe & Dohme, Philadelphia, under license from the Governors of the University of Toronto. Insulin-Mulford, 10 Units, 5 cc: Each cubic centimeter contains 10 units. Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Insulin-Mulford, 20 Units, 5 cc: 20 units. Insulin-Mulford, 40 Units, 5 cc. : 40 units. Insulin-Mulford, 10 Units, 10 cc. 10 units. Insulin-Mulford, 20 Units. 10 cc. 20 units. Insulin-Mulford, 40 Units, 10 cc. 40 units. Insulin-Mulford, 80 Units, 10 cc: Each cubic centimeter contains 80 units. Insulin-Mulford, 100 units, 10 cc: Each cubic centimeter contains 100 units. Beef pancreas is rendered as free from fat and connective tissue as possible, and extracted with acidulated 60 per cent alcohol. The mix- ture is centrifugalized and the gland residue reextracted with 60 per cent alcohol. The alcoholic liquid is then concentrated to about one- twelfth its original volume. The active substance is then precipitated with ammonium sulfate, and reprecipitated from an alcoholic solution. It is further purified by a method of iso-electric precipitation and is finally dissolved in acid water (pa 2.5) and preserved by the addition of 0.1 per cent cresol. It is then filtered through a Berkefeld filter, and submitted to sterility tests; its potency is determined by the method described under the preceding article. Insulin. Insulin-Squibb. — A brand of insulin. Manufactured by E. R. Squibb and Sons, New York, under license from the Governors of the University of Toronto. Insulin-Squibb, 10 Units, 5 cc: Each cubic centimeter contains 10 units. Insulin-Squibb, 20 Units, 5 cc. : 20 units. Insulin-Squibb, 40 Units, 5 cc: 40 units. Insulin-Squibb, 10 Units, 10 cc : 10 units. Insulin-Squibb, 20 Units, 10 cc: 20 units. Insulin-Squibb, 40 Units, 10 cc. : 40 units. Insulin-Squibb, 80 Units, 10 cc: 80 units. Imulin-Squibb, 100 Units, 10 cc: 100 units. Insulin-Squibb is made by extracting finely ground beef pancreas with acidulated aqueous alcohol and subsequently removing the tissue by centrifuging. The alcoholic solution is concentrated and the insulin is precipitated by ammonium sulfate after the removal of fats. This sulfate precipitate is dissolved in dilute ammonia and impurities removed by alcoholic precipitation. From the above filtrate the insulin is precipitated with ether and redissolved in ammonia. It is then reprecipitated at its iso-electric point pu 4.8-5.2. This nearly pure insulin precipitate is centrifuged and dissolved in acid water which is then passed through a Berkefeld filter and assayed. Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains J28 NEW AND NONOFFICIAL REMEDIES Insulin-Stearns. — A brand of insulin. Manufactured by Frederick Stearns and Company, Detroit, under license from the Governors of the University of Toronto. No U. S. trademark. Insulin-Stearns, 10 units. Insulin-Stearns, 20 units. Insulin-Stearns, 40 units. Insulin-Stearns, 10 units. Insulin-Stearns, 20 units. Insulin-Stearns, 40 units. Insulin-Stearns, 80 units. 10 Units, 5 cc. Each cubic centimeter contains 20 Units, 5 cc. : Each cubic centimeter contains 40 Units, 5 cc. 10 Units, 10 cc. 20 Units, 10 cc. 40 Units, 10 cc. Units, 10 cc 100 Units, 10 cc. 80 Each cubic centim.eter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Insulin-Stearns, 100 units. The method of preparation of insulin-Stearns is essentially that described in the Journal of Biological Chemistry, October, 1923, p. 717, et seq. The potency of insulin-Stearns is determined by the method described under the preceding article, "Insulin" and is checked by the mouse method of assay. Dilution of concentrated solutions to proper strength is made with sterile distilled water with a ^h of 2.5 and 0.1 per cent cresol is added. Final filtration is carried on through sterile Handler or Berkefeld filters, and the material is filled into sterile vials. Corroborative tests for unit-strength and sterility are made before any lot is released for use. Insulin-Toronto. — A brand of insulin. Prepared by the Connaught Laboratories, University of Toronto, Toronto, 5, Canada. Units, 10 cc: 20 Units, 10 cc: 40 Units, 10 cc: 80 Units, 10 cc: 100 Units. 10 cc: Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Each cubic centimeter contains Insulin-Toronto, 10 10 units. Insulin-Toro7ito, 20 units. Insulin-Toronto, 40 units. Insulin-Toronto, 80 units. Insulin-Toroiito 100 units. The method of preparation of insulin-Toronto is essentially as described in the Trans. Roy. Soc. Can., 1932, XXVI Sec. V, pp. 311-314. After a concentrated solution of the product has been prepared, its potency is determined, and the desired dilution of the solution is made with distilled water. Glycerine is then added, for purposes of iso- tonicity, as well as tricresol (0.1%), as a preservative. The solution is then passed through a gold-plated filter (Seitz). The filtrate is subjected to tests for stability, sterility and potency, and is released for use only in accordance with the results of these tests. Iletin (Insulin-Lilly). — A brand of insulin. Manufactured by Eli Lilly & Co., Indianapolis, under license from the Governors of the University of Toronto. U. S. trademark 171,971. Iletin (Insulin-Lilly) U-10, 5 cc: Each cubic centimeter contains 10 units. Iletin (Insulin-Lilly), U-20, 5 cc. : Each cubic centimeter contains 20 units. ORGANS OF ANIMALS 329 Iletin (Insulin-Lilly), U-40, 5 cc. : Each cubic centimeter contains 40 units. Iletin (Insulin-Lilly), U-10, 10 cc: Each cubic centimeter contains 10 units. Iletin (Insulin-Lilly), U-20, 10 cc: Each cubic centimeter contains 20 units. Iletin (Insulin-Lilly), U-40, 10 cc: Each cubic centimeter contains 40 units. Iletin (I insulin-Lilly) U-80, 10 cc: Each cubic centimeter contains 80 units. Iletin (Insulin-Lilly) U-lOO, 10 cc: Each cubic centimeter contains 100 units. Fresh pancreatic glands of animals, from which fat and connective tissue have been removed, are ground and extracted with 1 ^2 volumes 95 per cent alcohol, containing 0.11 per cent absolute sulfuric acid. The mixture is agitated during two hours and then filtered. The residue is again extracted using an equal volume of 70 per cent alcohol containing 0.11 per cent absolute sulfuric acid. This is filtered and the filtrate added to the first filtrate. The combined filtrates are chilled to C. and filtered. The filtrate is concentrated to about one twenty-fifth its original volume and filtered, and the filtrate added to 5.3 times its volume of 95 per cent alcohol. This mixture is allowed to stand for several hours, and then filtered, and the filtrate made up to contain 93 per cent alcohol. After standing several days, the precipitate formed is collected and dissolved in distilled water. The insulin preparation is further purified by precipitation at the isa electric point, the hydrogen ion concentration being adjusted to approxi- mately pn 4.7, after which the solution is allowed to stand in the ice- box. The precipitate formed is dissolved in acidified water (/>h 2.5), filtered, reprecipitated and redissolved if necessary for further purifi- cation. The solution is then diluted to approximately the desired potency, filtered through a Berkefeid filter, and submitted to standardi- zation and sterility tests. Parathyroid Gland Parathyroid preparations have been made from the dried gland for oral administration and by extracting substances from the gland for subcutaneous administration. The reports of success after oral therapy lack any conclusive evidence that this was dependent upon the use of the gland. No proof has been brought forward that the one definite effect that can be referred to the parathyroid gland (maintaining or raising the calcium concentration of the serum) has been produced by parathyroid preparations taken by mouth. To ascribe to the oral administration of parathyroid preparations improvement in conditions that are not definitely known to depend upon para- thyroid disease, or deficiency, is illogical and misleading. In consideration of the accumulated evidence of the ineffectiveness of oral therapy with parathyroid, preparations of parathyroid designed for oral administration are not accepted for inclusion in this book. Recent investigations have shown that prepara- tions which have a most powerful influence on calcium, metabolism may be made from the parathyroids of the ox. If this substance is injected intramuscularly or subcutaneously, the calcium concentration of the serum of animals deprived of their parathyroid glands can be raised and maintained at a normal limit. By repeated doses it may be raised far beyond 330 NEW AND NONOFFICIAL REMEDIES this, either in parathyroidectomized or in normal animals ; unless the dosage is carefully regulated, death may ensue. The prepa- rations can be standardized according to their activity in raising the calcium concentration in parathyroidectomized animals or in normal animals. On subcutaneous and intramuscular injec- tion the plasma calcium begins to rise in about 4 hours, reaches its maximum in from 12 to 18 hours and returns to the previous level in from 20 to 24 hours. Associated with the rise in plasma calcium is an increased urinary excretion of calcium and inorganic phosphate and a decrease in the plasma content of the latter. An immunity or tolerance to the hormone is induced by repeated administration. Treatment by these para- thyroid preparations has been shown to be of value in tetania parathyreopriva and in infantile tetany. In infantile tetany their employment would appear to be a temporary expedient until other measures have an opportunity to combat the fundamental underlying condition. In gastric tetany the calcium of the serum is normal, and it has not yet been demonstrated suffi- ciently that this condition can be affected beneficially by parathyroid therapy. The available clinical or scientific evidence does not permit an estimate of the ultimate usefulness of the parathyroid preparation in other conditions. The danger of hypercalcemia, which is easily induced by overdosage and which is associated with grave manifestations, makes it imperative that clinical studies should be controlled by blood serum cal- cium determinations. The normal concentration in man being approximately 10 mgm. of calcium per 100 cc. of serum, values above 12 mgm. are considered undesirable while those above 15 mgm. may be dangerous. SOLUTION OF P A R A T H Y R O I D.— Parathyroid Extract. — Parathyroid Extract-Hanson — "Contains the water- soluble principle or principles of the parathyroid glands which have the property of relieving the symptoms of parathyroid tetany and of increasing the calcium content of the blood serum in man and other animals. It is obtained from the fresh para- thyroid glands of healthy domesticated animals used for food by man. The parathyroid glands must be removed from the animals immediately after slaughtering, and then extracted at once or kept frozen until extracted. The glands are freed from gross fat and connective tissue, ground, extracted, and purified to make it suitable for parenteral administration. The solution is then adjusted to the proper potency by assay. "One cc. of Solution of Parathyroid possesses a potency equivalent to not less than 80 parathyroid units and not more than 120 parathyroid units, each unit representing one-hundredth of the amount required to raise the calcium level of 100 cc. of the blood serum of normal dogs 0.001 Gm. within from sixteen to eighteen hours after administration. The solution must be sterile."-C/. S. P. ORGANS OF ANIMALS 331 For standards see the U. S. Pharmacopeia under Liquor Parathyroidei. Actions and Uses (See preceding article, Parathyroid Gland). Dosage. — The average adult dose is 0.2 to 0.4 cc. (20 to 40 units) every twelve hours for five or six days, never more than ten days in succession. Treatment should then be dis- continued for a week or two, to be resumed if necessary. For children the initial dose should not exceed 0.1 to 0.2 cc. (10 to 20 units). Solution of parathyroid is administered subcutaneously or intramuscularly; not intravenously. Parathyroid Extract-Lilly. — A brand of solution of para- thyroid-U. S. P. Manufactured by Eli Lilly & Co., Indianapolis, by license under U. S. patent 1,890,851 (Dec. 13, 1932; expires 1949). No U. S. trade- mark. Parathyroid Extract-Lilly, 1 cc. Ampules: Each cubic centimeter con- tains 100 units. Parathyroid Extract-Lilly, 5 cc. Vials: Each cc. contains 100 units. Parathyroid Hormone-Squibb. — A brand of solution of parathyroid-U. S. P. Manufactured by E. R. Squibb & Sons, New York, by license under U. S. patent 1,890,851 (Dec. 13, 1932; expires 1949). No U. S. trade- mark. Parathyroid Hormone-Squibb, 5 cc. Vials: Each cc. contains 100 units. Paroidin. — A brand of solution of parathyroid-U. S. P. Manufactured by Parke, Davis & Co., Detroit. U. S. patent 1,890,851 (Dec. 13, 1932; expires 1949). U, S. trademark. Paroidin, 5 cc. Vials: Each cc. contains 100 units. Pituitary Gland Posterior Lobe. — The posterior lobe of the pituitary gland and the intermediate portion yield on extraction substances having a marked effect on plain muscle, especially that of the blood vessels and the uterus. The intravenous or intramus- cular injection of preparations of the posterior lobe is sometimes followed by an increase in blood pressure which is maintained over a considerable period of time. Injection of subsequent doses in such cases is followed by a similar effect unless repeated too soon after the first injection, when a fall in pressure may occur. The increase in pressure is due to an action on the smooth muscle of the vessels. In a considerable number of individuals the increase in blood pressure may be very slight and in some instances instead of an increase a definite lower- ing of the blood pressure may follow the injection of pituitary preparations. The heart is not stimulated in any case and may be depressed, either through the vagus response to a high blood pressure or by a direct action on the heart muscle itself or through impairment of its nutrition because of constriction of the coronary vessels. The tone of the intestinal tract may ZZ2 NEW AND NONOFFICIAL REMEDIES be markedly increased by direct action on the muscular coat. The administration of extracts usually retards the secretion of urine to a marked degree during the first hour and a half and sometimes longer. There is some experimental evi- dence to show that the absorption of water from the gastro- intestinal tract is delayed, thereby lessening the water available for secretion. However, the antidiuretic action may be due to increased reabsorption of water from the kidney tubules into the blood. The bladder musculature is stimulated especially when it has been previously in an atonic condition. Posterior pituitary extract does not increase the formation of milk, but apparently may cause a temporary acceleration of the output. The extract of the posterior lobe causes a marked constriction of the uterus by a direct stimulating action on the muscle. This occurs especially in pregnant and to a less extent in non- pregnant animals. Solutions prepared from the posterior lobe injected intramus- cularly are employed against uterine atony and in postpartum as well as in other forms of uterine hemorrhage. They should not be injected during the first stage of labor because, if the cervix be not fully dilated, energetic contractions may cause rupture of the uterus. They may be useful in intestinal paresis whether following abdominal operations or complicating infec- tious diseases. The extracts are also extensively used in diabetes insipidus, in which they reduce greatly the volume of urine excreted. For this purpose they need to be injected once or twice daily. The extracts should always be injected hypoder- mically or intramuscularly although some activity has been seen when they are applied to the nasal mucous membrane; similar activity has been noted on insufflation of dried and finely powdered posterior pituitary into the nose. The extract of the posterior lobe of the pituitary gland has been fraction- ated : one product (pitocin) acts on the uterus and a second product (pitressin) produces the characteristic efifect of the original solution on the blood vessels, intestine and urinary secretion. The result of this fractionation may arise from the separation of two distinct active principles or from the splitting of a single molecule into fractions having different activities. Anterior Lobe. — Hyperactivity of the anterior lobe has been supposed to produce gigantism and acromegaly, for clinically both conditions have been accompanied by tumors of the pitui- tary. On the other hand, hypoactivity of the anterior lobe has been held responsible for the syndrome dystrophia adiposogeni- talis, for this condition has also been found associated with tumors of that gland and experimental extirpation of the pitui- tary in dogs has often been accompanied by dystrophy, adiposity, and atrophy of the gonads and external genitalia. More recently evidence has accumulated which indicates that the hormone of the anterior lobe is essential to normal growth and the development of the ovaries and testes, but that it may have nothing to do with some of the other disturbances formerly ORGANS OF ANIMALS 333 attributed to abnormal functioning of the pituitary, as a consid- erable number of cases of Frohlich's syndrome have come to autopsy in which the pituitary has been histologically normal. It is also claimed that extirpation of the hypophysis in adult dogs and white rats without injury to the hypothalamus does not produce dystrophia adiposogenitalis. Extirpation in imma- ture animals is followed by cessation of growth and sexual development, a condition which has been corrected in white rats by daily transplants of the anterior lobe of the pituitary or by daily injections of appropriate amounts of the fresh extract of the anterior lobe of bovine glands. Present evidence would seem to indicate that a number of factors are concerned in the action of extracts of the anterior lobe: (1) a growth factor concerned with the development of the body; (2) a factor which stimulates the growth and matu- ration of the ovarian follicles, which in turn bring on the changes characteristic of estrus ; (3) a factor which causes luteinization of the ovarian follicles; (4) a factor which is necessary for normal thyroid development and function and which, if present in excess, produces hyperplasia of the thyroid with hyperthyroidism in both the rat and the guinea-pig ; (5) a factor which has been named Prolactin, which produces lacta- tion in mammals, and possibly plays a part in mammary gland proliferation ; it also induces a secretion of crop milk in pigeons ; (6) a diabetogenic principle associated with the growth hormone which decreased the hypoglycemic response to insulin and the absence of which leads to hypoglycemia and prevents in part the effects of pancreatectomy in dogs and toads ; and (7) a ketogenic principle, apparently distinct from the diabetogenic factor, which increases the ketone content of the blood in rabbits and rats. In addition to the above enumerated factors, the existence of which seems to be clearly established, experimental evidence has been offered indicating the presence of other principles ; among these are one which stimulates the adrenal cortex and one which stimulates the parathyroid glands. A gonadotropic substance which forms the basis of preg- nancy tests occurs in large amounts in the urine of pregnancy. Although this substance was originally considered to come from the anterior pituitary gland, the placenta which also yields it in large amounts seems to be a more probable source. It is pre- dominantly luteinizing in action in contrast to the principle found in the urine at the menopause and after castration which produces follicular stimulation. Pregnancy urine and placenta are the sources of most gonadotropic preparations available for clinical use. The Council believes that extensive clinical trial has failed to establish the value of desiccated pituitary preparations for oral administration whether these are prepared from the anterior or from the posterior lobe. 334 NEW AND NONOFFICIAL REMEDIES POSTERIOR PITUITARY.— Pituitarium Posterium U. S. P. XI. — Pituitary. — Hypophysis Sicca — "The cleaned, dried, and powdered posterior lobe obtained from the pituitary body of domesticated animals which are used for food by man. The pituitary body must be removed from the animal immediately after slaughtering and then dried at once or kept frozen until dried."- C7. S. P. For standards see the U. S. Pharmacopeia under Pituitarium Posterium. AMPOULES OF PITOCIN.— An aqueous solution con- taining the oxytocic principle of the posterior lobe of the pitui- tary gland (alphahypophamine) containing less than % unit of pressor activity per cubic centimeter. Five-tenths per cent of chlorbutanol is used as a preservative. It is standardized by the U. S. P. method for posterior pituitary, each cubic centimeter containing 10 units. Pitocin therefore has an activity on the uterus equal to that of the U. S. P. solution of pituitary. Actions and Uses. — Pitocin is used to stimulate uterine con- tractions in obstetrical practice. The use of the product may be particularly indicated in those cases in which increase of blood pressure is undesirable. Its use is contraindicated in contracted pelvis and in incomplete dilatation of the cervix. (See preceding article, Pituitary Gland.) Dosage. — From 0.3 cc. to 1 cc. (5 to 15 minims) intramus- cularly. If used before delivery is completed, small doses are used, repeated if necessary in twenty to thirty minutes. Manufactured by Parke, Davis & Co., Detroit. U. S. patent 1,960,493 (May 29, 1934; expires, 1951). U. S. trademark 254,956. Ampoules of Pitocin, 0.5 cc: Each ampule contains more than 0.5 cc. Ampoules of Pitocin, 1 cc: Each ampule contains more than 1 cc. AMPOULES OF PITRESSIN.— An aqueous solution containing the pressor and diuretic-antidiuretic principle of the posterior lobe of the pituitary gland (betahypophamine) con- taining less than 1 unit of oxytocic activity per cubic centimeter. Five-tenths per cent of chlorbutanol is used as a preservative. It is standardized by the method of Hamilton and Rowe (/. Lab. & Clin. Med. 2:120 [Nov.] 1916) so that each cubic centimeter contains 10 pressor units (1 unit represents the pressor activity exhibited by 0.5 mg. of standard powdered pituitary-U. S. P.). Actions and Uses. — Pitressin is used for raising the blood pressure, for increasing the muscular activity of the bladder and intestinal tract, also for antidiuretic effect in diabetes insipidus. (See preceding article, Pituitary Gland.) Experimental evidence has been obtained indicating that the product increases the blood sugar and it has been successfully employed to counteract overdoses of insulin in animals. No clinical studies to determine the value for this purpose have been reported so far. It has been suggested that the product ORGANS OF ANIMALS 335 may be of value either in conjunction with or supplementary to the use of epinephrine in the treatment of serum sickness and similar vasomotor disturbances, but no definite evidence on this point is as yet available. Dosage. — From 0.3 to 1 cc. (5 to 15 minims) intramuscularly, repeated as may be indicated. Manufactured by Parke, Davis & Co., Detroit. U. S. patent 1,960,493 (May 29, 1934; expires 1951). U. S. trademark 254,507. Ampoules of Pitressin, 1 cc: Each ampule contains more than 1 cc. SOLUTION OF POSTERIOR PITUITARY.— Liquor Pituitarii Posterioris U. S. P. XL— Solution of Pituitary— "Con- tains the water-soluble principle or principles from the fresh pos- terior lobe of the pituitary body of healthy domesticated animals used for food by man. The pituitary body must have been removed from the animal immediately after slaughtering, and then extracted at once or kept frozen until extracted. One cc. of Solution of Posterior Pituitary produces an activity upon the isolated uterus of the virgin guinea-pig, corresponding to not less than 80 per cent and not more than 120 per cent of that produced by 0.005 Gm. of the Standard Powdered Posterior Pituitary, prepared as directed in the U. S. Pharmacopeia. The solution must be sterile.''-^/. S. P. For methods of assay see the U. S. Pharmacopeia under Liquor Pituitarii Posterioris. Actions and Uses. — See preceding article. Pituitary Gland. Dosage. — For use in obstetrical cases, from 0.2 to 1 cc. (5 to 15 minims) ; in surgical cases, from 1 to 2 cc. (15 to 30 minims), preferably by deep intramuscular injection or subcutaneously. Pituitary Solution. — A brand of solution of posterior pitui- tary-U. S. P. Manufactured by Abbott Laboratories, North Chicago, 111. Pituitary Liquid (U. S. P.) Armour. — A brand of solution posterior pituitary-U. S. P. Manufactured by Armour & Company, Union Stock Yards. Chicago, Pituitary Extract-Lilly-U. S. P. — A brand of solution of posterior Pituitary-U. S. P. Manufactured by Eli Lilly & Co., Indianapolis. Pituitary Extra ct-U. S. P.-Merrell. — A brand of solution of posterior pituitary-U. S. P. Manufactured by Wm. S. Merrell Company, Cincinnati. Pituitrin. — A slightly acid aqueous solution containing the water-soluble principles of the fresh posterior lobe of the pitui- tary body of cattle, of the same strength as solution of pituitary- U. S. P., preserved by the addition of chlorbutanol, each cubic 336 NEW AND NONOFFICIAL REMEDIES centimeter containing 0.005 Gm. It is standardized (1) for oxytocic action by the method of the U. S. P., and (2) by its effect on blood pressure according to the method of Hamil- ton and Rowe (/. Lab. & Clin. Med. 2:120 [Nov. J 1916). Actions and Uses. — See preceding article, Pituitary Gland. Dosage. — See Solution of Posterior Pituitary. Manufactured by Parke, Davis and Co., Detroit. No U. S. patent. Trademark 76,722. Ampoules Pituitrin, 0.5 cc. Ampoules Pituitrin, 1 cc. Pituitary Solution-Squibb. — A brand of solution of pos- terior pituitary-U. S. P. Manufactured by E. R. Squibb & Sons, New York. Pituitary Solution (U. S. P.)-Wilson. — A brand of solu- tion of posterior pituitary-U. S. P. Manufactured by Wilson Laboratories, Chicago. Thyroid THYROID. — "The cleaned, dried, and powdered thyroid gland previously deprived of connective tissue and fat. It is obtained from domesticated animals that are used for food by man. Thyroid contains not less than 0.17 per cent and not more than 0.23 per cent of iodine in thyroid combination, and must be free from iodine in inorganic or any form of combination other than that peculiar to the thyroid gland. A desiccated thyroid of a higher iodine content may be brought to this stand- ard by admixture with a desiccated thyroid of a lower iodine content or with lactose or sodium chloride." U. S. P. For standards see the U. S. Pharmacopeia under Thyroideum. THYROXINE.— See under Thyroxine. PARRESINE. — A mixture composed of paraffin (melting point 48 to 49 C), from 94 to 96 per cent; gum elemi, from 0.20 to 0.25 per cent; Japan wax, from 0.40 to 0.50 per cent, asphalt, from 0.20 to 0.25 per cent, and eucalyptol, 2 per cent. To this mixture is added from 0.5 to 1.0 per cent solution of alkannin in eucalyptol and a minute quantity of gentian violet, these being employed to bring the product to a standard color. Alarketed only in the form of Parresined Lace Alesh Surgical Dressing. Actions, Uses and Dosage. — Non-absorbent protective, used for the preparation of Parresined Lace Mesh Surgical Dressing. Prepared by the Abbott Laboratories, North Chicago, Illinois. No U. S. patent. U. S. trademark, 117,626. PENTNUCLEOTIDE.— The sodium salts of the pentose nucleotides from the ribonucleic acid of yeast. Pentnucleotide is prepared from yeast nucleic acid by hydrolysis for twenty- four hours with 1 per cent sodium hydroxide solution. The lead salts prepared from the acidified hydrolyzed solution are PENTNUCLEOTIDE ZZI decomposed with hydrogen sulfide and the Hberated acids are concentrated and precipitated with alcohol. The sodium salts are prepared by neutralization with sodium hydroxide. The final product is approximately an 8 per cent solution of the sodium salts of what appear to be four nucleotides ; the solu- tion has a pB. of 7.2 and is preserved with cresol, 0.3 per cent. Actions and Uses. — Pentnucleotide is proposed for use in infectious conditions accompanied by a leukopenia or neutro- penia, such as agranulocytic angina but its usefulness in other forms of sepsis remains to be demonstrated. Immediately fol- lowing the intravenous administration of pentnucleotide there is usually a sharp, temporary reaction characterized by dyspnea, precordial distress, bradycardia and sweating. Following intra- muscular use, similar reactions have occasionally been reported but in milder form ; generally no reaction occurs. On or about the fifth day following the use of pentnucleotide in cases marked by extreme lowering of the leukocyte count the total and dif- ferential white blood cell count begins to return to normal. With the return of the blood picture to normal there is a corresponding improvement in the clinical picture. Dosage. — In usual cases the contents of one vial (10 cc), undiluted, are injected into the gluteal muscle twice a day until the white blood cell count has risen definitely, and thereafter once a day until the white blood cell count has been at a normal figure for at least three days. Should the white blood cell count fall again, intensive treatment should be resumed. In desperately ill cases the contents of two vials (20 cc.) are injected into the gluteal muscles twice a day for four suc- cessive days. After four days the contents of one vial (10 cc.) are injected intramuscularly twice a day until the white blood cell count has risen definitely, and thereafter once a day until the white blood cell count has been at a normal figure for at least three days. Manufactured by Smith, Kline & French Laboratories, Philadelphia, Pa. No U. S. patent. U. S. trademark 301,527. Vials Pentnucleotide, 10 cc. Pentnucleotide is a clear pale yellow solution having a mildly saline taste. The dry salt is very hygroscopic when exposed to air. Treat 10 cc. of pentnucleotide with 10 cc. of hydrochloric acid and boil the mixture for two minutes: aniline acetate paper susjiended in the vapors acquires a rose red color (furjnral from ribosc) . Neutralize the solution with stronger ammonia water, add 2 cc. of diluted hydro- chloric acid, filter, make alkaline with ammonia water and set aside: a precipitate forms on standing. Filter and wash the i)recipitate with water, moisten with 0.5 cc. of diluted nitric acid and follow with 1 cc. of water; evaporate a few drops of the acid filtrate to dryness on a porcelain dish on a water bath, add 0.15 cc. of i)otassiuni Iiydroxide solution (10 per cent) and again evaporate to dryness: a i)in))lish to rosy or brownish red coloration forms (gnanidine). To 10 cc. of the ammoniacal filtrate add 5 cc. of 10 per cent calcium chloride solution: a gelatinous precipitate forms; filter and wash with water; add 1 cc. nf diluted nitric acid to the precipitate; wash with 2 cc. of water; to the dissolved precipitate add 0.5 cc. ammonium molybdate solution: a yellow coloration and a yellow precipitate forms on gentle warming (phosphates). Treat 5 cc. of pentnucleotide with 5 cc. of a solution of brucine acetate (10 per cent): a white precipitate forms, becoming crystalline on 338 NEW AND NONOFFICIAL REMEDIES standing. To 5 cc. of pentnucleotide add 5 cc. of sodium hydroxide solution (10 per cent): not more than a slight precipitate appears; add 0.1 cc. of 1 per cent copper sulphate solution: no violet nor purple coloration is produced (biuret) ; add 1 cc. of 1 per cent copper sulphate solution: no marked precipitate is produced (gums). To 5 cc. of pentnucleotide add 1 cc. of diluted hydrochloric acid and an equal volume of freshly prepared hydrogen sulphide water; treat according to U. S. P. test for heavy metals: no more color change is shown than when 5 cc. of pentnucleotide is treated with 1 cc. of diluted hydrochloric acid and an equal volume of water. To 5 cc. of pentnucleotide add several drops of silver nitrate solution (10 per cent): a white precipitate forms, which dissolves on shaking the mixture. To 5 cc. of pentnucleotide add 10 cc. of lead acetate solution and 0.2 cc. of glacial acetic acid: a white precipitate forms. Agitate the mixture for one or two minutes and filter with suction; wash the precipitate well with water; suspend in 15 cc. of distilled water, and treat with excess hydrogen sulphide; stir well, and filter into a tared flat shallow weighing dish; evaporate nearly to dryness on the steam bath; add about 5 cc. of dehydrated alcohol, evaporate the alcohol, then dry in a vacuum desiccator over sulphuric acid to constant weight; dissolve the dried substance in 10 cc. of water: add one drop of phenolphthalein indicator solution and titrate with tenth normal sodium hydroxide solution: not more than 63.5 cc. nor less than 57.5 cc. of tenth normal sodium hydroxide is consumed per gram of dried sub- stance. Evaporate a 5 cc. portion of pentnucleotide to dryness in a shallow dish over a steam bath; dry for twenty-four hours in a desiccator: not more than 0.45 Gm., nor less than 0.41 Gm. of solid residue results. PEROXIDES Hydrogen peroxide is a combination of two atoms of hydro- gen with two atoms of oxygen, one of the latter being given off to oxidizable substances, leaving a residue of water. In the presence of catalase, a ferment found in all cells, it is readily decomposed. The liberated oxygen sometimes causes consid- erable effervescence. For this reason it is dangerous to inject it into closed body cavities or into abscesses from which the gas has not a free exit. Hydrogen peroxide solution (liquor hydrogenii dioxidi) is official in the U. S. Pharmacopeia. This preparation is germicidal when diluted with not more than twice its volume of water. Diluted with an equal volume of water it destroys typhoid bacilli in two and one-half minutes. Metallic Peroxides Metallic peroxides are compounds in which the hydrogen of hydrogen peroxide has been replaced by metals, and which are readily decomposed with liberation of hydrogen peroxide, or of oxygen. Actions and Uses. — Like hydrogen peroxide, the metallic peroxides depend for their value on the readiness with which a part of their oxygen becomes active. They are claimed to possess advantages over solution of hydrogen peroxide, because the oxygen is set free more gradually. Among themselves the metallic peroxides differ in their action in accordance with their solubility and the alkalinity produced by interaction of the peroxide with water. The action of peroxides is also affected by the nature of the metal which goes into solution PEROXIDES 339 when the peroxide is decomposed. Thus, the use of sodium peroxide is limited by the strong base formed when it dissolves in water. Because of the strong oxidizing effects on the lower organ- isms, the peroxides have been recommended as a convenient means of sterilizing water. CALCIUM PEROXIDE.— Calcii Peroxidum.— A mix- ture consisting essentially of calcium peroxide (the calcium salt, Ca02, of hydrogen peroxide) and calcium hydroxide and car- bonate, containing not less than 60 per cent calcium peroxide, equivalent to 13.3 per cent available oxygen. Actions and Uses. — See preceding article. Metallic Peroxides Dosage. — From 0.06 to 0.3 Gm. (1 to 5 grains) in water or with sodium bicarbonate, two to three times daily. Calcium peroxide is a light, cream-colored, odorless and tasteless powder. It is practically insoluble in water, but by such contact it is gradually decomposed into hydrogen peroxide and calcium hydrox- ide, the hydrogen peroxide being further decomposed by the alkaline calcium hydroxide with liberation of oxygen. It is decomposed by dilute acids with_ formation of a solution containing hydrogen peroxide. If a few milligrams of calcium peroxide is shaken with 10 cc. of water and 1 drop of diluted sulfuric acid, and a few cubic centime- ters of ether added, the subsequent addition of a drop of potassium dichromate solution will produce a blue color in the aqueous layer. On shaking the mixture, the blue will pass into the ethereal layer. If 1 Gm. of calcium peroxide is dissolved in 25 cc. of diluted nitric acid and 2 cc. of tenth-normal silver nitrate added to the solution and the resulting precipitate filtered off, the further addition of a few drops of silver nitrate solution to the filtrate will produce no tur- bidity. If 1 Gm. of calcium peroxide is exposed to the full heat of a Bunsen flame for five minutes, then dissolved in 25 cc. diluted hydro- chloric acid and the solution made up to 100 cc, a solution will_ result which will conform to the following tests: Ten cc. of the solution, to which ammonium hydroxide in excess has been added, will yield a white precipitate on the addition of ammonium oxalate solution. Ten cc. of the solution saturated with hydrogen sulfide will yield no precipitate, nor become colored. Ten cc. of the solution will yield not more than a turbidity on the addition of barium chloride solution. Ten cc. of the solution, after addition of a slight excess of ammonium hydroxide and acidification with acetic acid, will yield no turbidity on the addition of potassium dichromate solution. If from 0.2 to 0.3 Gm. of calcium peroxide, weighed into a flask, is shaken with 25 cc. of water, then 25 cc. of diluted hydrochloric acid added, the titration of this solution with tenth-normal potassium permanganate will indicate the presence of not less than 60 per cent of calcium peroxide. SODIUM PEROXIDE.— Sodii Peroxidum.— NasOa.— The sodium compound analogous to hydrogen peroxide, con- taining at least 90 per cent of sodium peroxide. Actions and Uses. — Sodium peroxide is not used internally, but has been used in acne, applied in the form of a paste pre- pared with liquid paraffin, or as a soap to remove comedones. Sodium peroxide occurs in the form of a whole, or yellowish, amor- phous powder. It is soluble in water, with decomposition and evolution of heat, forming an alkaline solution and liberating oxygen. It dis- solves in cold dilute acids, forming a solution of hydrogen peroxide. When heated, sodium peroxide becomes darker, but on cooling resumes its original color. It does not react with alcohol, but it ignites ether on 340 NEW AND NONOFFICIAL REMEDIES contact. A mixture with red phosphorus explodes under pressure on being struck. It is an extremely powerful oxidizing agent. Sodium peroxide should not respond to tests for sulfates, chlorides, phosphates, nitrates and heavy metals. If 1 Gm. or 1.5 Gm. of sodium peroxide is weighed and gradually added with constant stirring to 950 cc. of diluted sulfuric acid (1 per cent) and the solution made up to 1,000 cc, the titration of 100 cc. of this solution with tenth normal potassium permanganate will indicate the presence of not less than 90 per cent sodium peroxide. Sodium Peroxide-Merck. — A brand of sodium peroxide- N. N. R., containing not less than 96 per cent of sodium peroxide. Merck & Co., Inc., Rahway, N. J., distributor. PETROLATUM.— Petroleum Jelly.— "A purified, semi- solid mixture of hydrocarbons obtained from petroleum." U. S. P. For standards see the U. S. Pharmacopeia and under Petrolatum. Petrobran. — Each 100 Gm. contains: petrolatum, 74 Gm. ; bran, 22 Gm., with powdered licorice and "oil of pineapple" (ethyl butyrate) sufficient to flavor. Prepared by Sargent's Drug Store, Chicago. No U. S. trademark. PHENETIDIN DERIVATIVES The phenetidins (derivatives of para-aminophenol C6H4(NH2) (OH), 1 : 4) comprise chemical relatives of aniline (aminoben- zene). The members of this group have similar properties and are more or less active, according as they undergo decomposi- tion in the system, so as to yield either para-aminophenol or acetylaminophenol. They have a more or less pronounced action on the blood, by which they produce hemolysis and destruction of the red blood corpuscles. They also act as heart depressants. Acetophenetidin and its congeners are antipyretics and anal- gesics. They are extensively employed for the relief of pain, but for this purpose they should be used with caution in con- sideration of their poisonous properties. They have also been considerably employed for the reduction of temperature in fever. Nearly every newly discovered product related to acetophenetidin has been heralded as a "safe" anti- pyretic and free from poisonous effects on the blood and heart. Invariably, extended clinical experience has shown that all these preparations are, to a greater or less degree, hemolytic and depressing to the circulation. Hence their employment in the infectious fevers should be most cautious. ACETOPHENETIDIN.— Acetphenetidinum U. S. P. X. — Phenacetin. — Paraacetaminophenetol. For standards see the U. S. Pharmacopeia under Aceto- phenetidinum. PHYSIOLOGIC SALINE SOLUTIONS 341 Phenacetin. — A name applied to acetophenetidin. See the U. S. Pharmacopeia. The tests of identity and purity prescribed by the United States Pharmacopeia under acetophenetidin should apply to the product dispensed under this title. PHENACAINE.— See Anesthetics, Local. PHENETSAL. — Phenetsalum. — Salophen. — Acetyl-/>- aminophenyl Salicylate. — Acet-Z^-aminosalol. — 1 : 4-Acetamino- phenyl Salicylate. — C6H40H.CO.O.C6H4(NHCH3CO). The salicylic acid ester of 1 : 4-acetaminophenol, C6H4(NHCH3CO) (OH). Actions and Uses. — The actions of phenetsal resemble those of phenyl salicylate (salol). It is not changed in the stom- ach, but is broken up in the intestine, liberating salicylic acid and paramidophenol (which is less toxic than phenol). It acts as an antirheumatic, antipyretic, antiseptic and anal- gesic. It is said to be useful in rheumatism, gout, typhoid fever, and as an intestinal antiseptic, in diarrhea and dysen- tery. Externally, it has been applied in psoriasis and other itching skin diseases. Dosage. — From 0.3 to 1 Gm. (5 to 15 grains), in powder wafers or capsules. Externally, in 10 per cent ointment. Phenetsal forms small, white, crystalline leaflets or powder, odorless and tasteless, melting at from 187 to 188 C. It is almost insoluble in cold water, more soluble in warm water, freely soluble in watery solutions of the alkalis and in alcohol, ether and benzene, but not in petroleum benzin. If its alkaline solution is boiled, it gradually becomes blue; on con- tinuing the boiling the color is discharged, but is again produced on cooling and exposure to air. On the addition of ferric chloride to the alkaline solution, the violet color characteristic of salicylic acid is produced, but a simple aqueous solution of phenetsal does not react with ferric chloride and should not be changed by silver nitrate. It forms a colorless solution with concentrated sulfuric acid. It is incompatible with alkalis, which decompose it. Salophen. — A brand of phenetsal-N. N. R. Manufactured by Winthrop Chemical Company, N. Y. No U. S. patent. U. S. trademark 20,759. Winthrop Tablets of Salophen, 5 grains. PHYSIOLOGIC SALINE SOLUTIONS Physiologic solution sodium chloride (U. S. P.) is the most commonly used saline solution. Various modifications have found wide acceptance particularly those containing metallic ions found in the blood, the one most commonly referred to being Ringer's Solution, In addition, adaptations of Ringer's Solution have been used, such as those containing sodium lactate for the buffering action. (For Solutions of Sodium Chloride with Dextrose see under Dextrose. For Ringer's Solution combined with dextrose, see under Dextrose.) 342 NEW AND NONOFFICIAL REMEDIES PHYSIOLOGICAL SOLUTION OF SODIUM CHLORIDE-U. S. P.— Physiological Salt Solution, Normal Saline Solution. For standards see U. S. Pharmacopeia under Liquor Sodii Chloridi Physiologicus. Physiological Sodium Chloride Solution in Vacoliter Containers. Prepared by Baxter Laboratories, Inc., Glenview, 111. (American Hos- pital Supply Corporation, Chicago, distribvitor.) Physiological Sodium Chloride Solution in Half-Size Vacoliter Con- tainers. Prepared by Baxter Laboratories, Inc., Glenview, 111. (American Hos pital Supply Corporation, Chicago, distributor.) Physiological Solution of Sodium Chloride in Saftiflask Container. Prepared by Cutter Laboratories, Berkeley, Calif. Physiologic Solution of Sodium Chloride in Filtrair Dispenser. Prepared by Hospital Liquids, Inc., Chicago. Sterisol Ampoule Physiological Solution of Sodium Chloride. Prepared by Sterisol Ampoule Corporation. Long Island City, N. Y. Physiological Solution of Sodium Chloride, 50 cc. Bottle. Prepared by United States Standard Products Co., Woodworth, Wisconsin. Physiological Solution of Sodium Chloride, 100 cc. Bottle. Prepared by United States Standard Products Co., Woodworth, Wisconsin. RINGER'S SOLUTION.— Aqueous solution containing, in 1,000 cc, sodium chloride 7.0 Gm., potassium chloride 0.30 Gm., and calcium chloride 0.25 Gm. Actions and Uses. — Ringer's Solution is used when chlorides and sodium, potassium and calcium have been diminished. It is indicated in all forms of dehydration but particularly in cases in which loss of gastro-intestinal secretions has resulted from vomiting, diarrheas or fistulas. It is also used in acidosis or alkalosis for improvement of circulation and stimulation of renal activity. Dosage. — Ringer's Solution is given by all parenteral routes, chiefly subcutaneously and intraperitoneally. Ringer's Solution in Filtrair Container: Each 100 cc. contains sodium chloride-U. S. P. 0.7 Gm., potassium chloride-U. S. P. 0.03 Gm., and calcium chloride (anhydrous) 0.025 Gm. Marketed in bottles (Filtrair containers) of 500 and 1,000 cc. Prepared by Hospital Liquids, Inc., Chicago. Ringer's solution occurs as a clear, colorless solution, possessing a slightly saline taste. The specific gravity is from 1.005 to 1.006 at 25 C. Twenty -live cc. of the solution concentrated to 10 cc. conforms to the U. S. P. XI test for heavy metals; 10 cc. of the solution con- forms to the U. S. P. XI test for arsenic. Concentrate 20 cc. of Ringer's solution to a volume of 5 cc, transfer to a test tube, add 1 cc. of freshly prepared sodium cobaltic nitrite solution, dilute to 10 cc, and mix thoroughly; prepare a standard solu- tion of potassium chloride as follows: dissolve 1.5 Gm. of potassium chloride (dried at 200 C.) to make 1,000 cc. of solution. Transfer 4 cc. and 5 cc portions of the standard potassium chloride solution to test tubes and add 1 cc. of freshly prepared sodium cobaltic nitrite solution. Dilute each portion of the standard to 10 cc, and mix thoroughly: the turbidity produced by the Ringer's solution at the end of ten minutes is less than that produced by 5 cc. and more than that produced by 4 cc of the standard solution (limit of potassium [K+]). Transfer 5 cc of Ringer's solution to a Nessler tube, add O.S cc. of diluted acetic acid, 40 cc. of water, and 5 cc. of ammonium oxalate PHLORHIZIN 343 solution; dilute to 50 cc, and mix thoroughly; prepare a standard cal- cium acetate solution by dissolving 0.287 Gm. of precipitated calcium carbonate (dried at 200 C.) in 15 cc. of water containing 3 cc. of acetic acid and diluting to 250 cc. Transfer 1 cc. and 1.25 cc. portions of this standard solution to Nessler tubes, add 40 cc. of water and 5 cc. of ammonium oxalate solution and dilute to 50 cc: the turbidity pro- duced by 5 cc. of the Ringer's solution is less than that produced by 1.25 cc. and more than that produced by 1 cc. of the standard solution at the expiration of fifteen minutes (/imif of calcium [Ca++]). Transfer 25 cc. of Ringer's solution to a weighing dish, evaporate to dryness on the steam bath, place in oven at 150 C. for two hours, cool in a desiccator, and weigh: the weight of residue obtained is not less than 0.18 Gm. and not more than 0.19 Gm. Treat 25 cc. of Ringer's solution with an excess of sulfuric acid, evaporate to dryness, and ignite to constant weight at 750 C: the weight of ash obtained is not less than 0.22 Gm. nor more than 0.23 Gm. Transfer 10 cc. of Ringer's solution to a 400 cc. beaker, add 50 cc. of water and 4 cc. of diluted nitric acid; dilute to 200 cc, add 15 cc. of silver nitrate solution, heat to boiling and allow to stand until the precipitate is granular. Filter onto a weighed gooch crucible previously heated to 150 C; wash the precipitate well with hot water; dry to constant weight at 140 to ISO C: the chloride (CI") calculated from the silver chloride weight is not less than 0.0435 Gm. nor more than 0.0465 Gm. PHLORHIZIN.— Phlorhizinum.— Phlorizin.— C21H24O10+ 2H2O. — A glucoside from the root of the apple, pear, cherry, etc. Actions and Uses. — Phlorhizin destroys malarial parasites in vitro. When administered to man or animals, it produces glycosuria of renal origin. Polyuria is also produced. It has been recommended as an antiperiodic in malaria ; but its use in this disease is not justified in view of the possible injury to the kidney which it may cause. It is used as a means of testing the functional activity of the kidney. Dosage. — To test the permeability of the kidney, 0.005 Gm. (VI2 grain) is dissolved in 1 cc. (15 minims) of a 0.5 per cent solution of sodium carbonate and injected hypodermi- cally. Dextrose should appear in the urine in from fifteen minutes to one-half hour and the secretion of sugar should continue for from two to four hours. The test gains in diag- nostic value if the urine of each kidney is collected separately. Phlorhizin may be given by mouth in pills massed with glu- cose syrup or suspended in a mixture with acacia or traga- canth. The internal dose is from 0.3 to 0.6 Gm. (5 to 10 grains). Phlorhizin occurs as minute white, slightly pinkish crystals, of a silky texture, or as a pale yellow, light crystalline powder, odorless and having a bitter, but later a sweet, taste. It is sparingly soluble in cold, but freely soluble in hot water, from which it crystallizes on cooling. It is soluble in alcohol (1 in 4) sparingly soluble in ether. The solutions are levogyrate. At 100 C. it loses water and at about 107 C. melts. When heated to about 130 C, it becomes solid again and melts again at about 170 C. At about 200 C. it assurnes a red color, due to the formation of rufin. Boiled with dilute acids, it is converted into sugar, phlorose and phloretine. Exposed to air in the presence of ammonia, it assumes a purple color. Cold concentrated sulfuric acid dissolves it to a yellow solution and at from 25 to 50 C. the solution becomes red. 344 NEW AND NONOFFICIAL REMEDIES PSYLLIUM SEED. — Plantago Seed. — Plantain Seed. — "The cleaned, dried, ripe seed of Plantago Psyllium Linne, or of Plantago arenaria (P. ramosa [Gilib.] Aschers) Wadsstein et Kitaibel, known in commerce as Spanish or French Psyllium Seed; or of Plantago ovata Forskal, known in commerce as Blonde Ps341ium or Indian Plantago Seed (Fam. Planfagi- naceae). "Plantago Seed contains all of its natural mucilage and not more than 0.5 per cent of foreign organic matter. It yields not more than 4 per cent of total ash and not more than 1 per cent of acid-insoluble ash." A^. F. For standards see the National Formulary, under Plantaginis Semen. Actions and Uses. — Psyllium seed, by virtue of its indigesti- bility and mucilaginous character, acts as a mild laxative. The addition of ground psyllium seed to the food of rats and dogs has been found to be followed by darkening of the kidneys ; and when prolonged its use was followed by the appearance of microscopic pigment granules in the tubules of rats. The sig- nificance of this has not been determined, but until the ground psyllium seed shall have been shown to be harmless to man, no product of that type will be accepted by the Council. No such effect was observed after feeding the whole psyllium seed. Dosage. — From 4 to 15 Gm. (1 to 4 drachms) one to three times a day. Psyllium seed may be mixed with orange juice or prune juice and eaten without mastication, or the dose may be mixed with a little hot water and the resulting gelatinous mass spread on bread or taken with other food. Richards Psyllium Seed. — A brand of psyllium seed (plan- tago seed). Prepared by Richards Pharmacal Co., Inc., New York. Schieffelin Psyllium Seed. — A brand of psyllium seed (plantago seed). Prepared by Schieffelin & Co. New York, N. Y. No U. S. patent or trademark. PYRAZOLON DERIVATIVES The preparations in this group are used for their anti- pyretic and analgesic action. There is reason to believe that they have less tendency to disintegrate the red blood cor- puscles than have the phenetidin compounds, but in other respects they are open to the same objections. On taking small doses, some susceptible individuals experience nervous and circulatory depression, while after large doses instances of collapse have been reported. PYRAZOLON DERIVATIVES 345 The following pyrazolon derivatives are included in New and Nonofficial Remedies : Melubrin, a complex synthetic differing from antipyrine in that a sodium amino-methyl sulphite has replaced the hydro- gen atom of the pyrazolon group. In this it is asserted that the toxicity is very much reduced. Aminopyrine (pyramidon) chemically known as dimethyl- amino antipyrine. Antipyrine Compounds and Derivatives ANTIPYRINE. — Phenazone. — "Phenyldimethylpyra- zolon."-L^. S. P. For standards see the U. S. Pharmacopeia under Antipyrina. MELUBRIN. — Sodium antipyrine aminomethansulfonate. Sodium -l-phenyl-2,3-dimethyl-5-pyrazolon -4 -aminomethansulfo- nate. The sodium salt of l-phenyl-2,3-dimethyl-5-pyrazolon- 4-aminomethansulfonic acid, differing from antipyrine, C11H12N2O, in that a sodium aminomethansulfonate group, NH.CH2S03Na, has replaced a hydrogen atom of the pyra- zolon group. Actions and Uses. — It is claimed that melubrin in ordinary or even large doses is not toxic. In moderate doses, it is said to have almost no effect on the circulation or respira- tion. It acts as a powerful antipyretic in fever and it is analgesic. Melubrin is said to be useful in painful affections, such as sciatica and other neuralgias, and as an antipyretic in various febrile affections. It is said to have effects similar to those of the salicylates in acute rheumatism. Dosage. — From 1 to 2 Gm. (15 to 30 grains). The larger doses are recommended for the treatment of rheumatism. It is claimed that as much as 10 Gm. (150 grains) may be given daily. Manufactured by Farbwerke, vorm. Meister, Lucius and Bruening, Hoechst, a. M., Germany (Winthrop Chemical Co., Inc., New York). U. S. patent 1,056,881 (March 5, 1913; expired). U. S. trademark 88,562. Melubrin is prepared by allowing a solution of formaldehyde bisul- fite to act on l-phenyl-2,3-dimethyl-4-amino-pyrazolon, and purifying the resulting product by recrystallization. It is a white, odorless, almost tasteless crystalline powder, readily soluble in water, but slightly soluble in alcohol. The aqueous solution is neutral in reaction but unstable. If about 0.2 Gm. of melubrin dissolved in 5 cc. of water is boiled with 3 cc. of diluted hydrochloric acid, sulfur dioxide and formalde- hyde will be liberated. If half of the solution thus formed is treated with 3 drops of sodium nitrite solution and 5 cc. of an alkaline solution of betanaphthol, a red precipitate will be produced. If the remainder of the solution is treated with 1 Gm. of sodium acetate and 15 cc. of a saturated aqueous benzaldehyde solution a yellowish-white, flocculent precipitate will be formed which, when washed and dried, will melt at 173 C. If a small quantity of melubrin is moistened with hydro- 346 NEW AND NONOFFICIAL REMEDIES chloric acid, it will respond to the flame test for sodium. If a 10 per cent aqueous solution of melubrin is made alkaline with ammonia water saturation with hydrogen sulfide should produce no change. If 0.5 Gm. of melubrin is thoroughly mixed with 4 Gm. of sodium nitrate and gradually heated, 4 cc. of concentrated sulfuric acid added to the resulting mass, and the mixture heated until no further white fumes are produced, the resulting substance powdered and mixed with 10 cc. of saturated hydrochloric acid solution of stannous chloride, no dark- ening will occur within one hour. If from 0.4 to 0.5 Gm. of melubrin is weighed in a platinum dish, treated with dilute sulfuric acid, and heated to constant weight, the sodium sulfate thus formed will weigh from 0.2160 to 0.2250 Gm. for each gram of material used, representing a sodium content of from 6.99 to 7.28 per cent. Aminopyrine and Aminopyrine Derivatives AMINOPYRINE.— Amidopyrina U. S. P. X.— "Dimethyl- aminophenyldimethylpyrazolon." U. S. P. For standards see the U. S. Pharmacopeia under Amino- pyrina. Actions mid Uses. — Aminopyrine acts as an antipyretic and anodyne, similarly to antipyrine, but is effective in smaller doses. The action, while somewhat slower at the beginning, is more lasting. It is claimed to be comparatively free from harmful influences on the blood, heart or kidneys. It is said to be useful, particularly in the chronic fevers of tuberculosis, as well as in the acute febrile conditions incident to typhoid fever, erysipelas and pneumonia. In the treatment of infectious fevers, it, as other antipyretics, should be cautiously employed. See general article, Phenetidin Derivatives. Aminopyrine appears to pro- duce serious and sometimes fatal granulocytopenia especially in susceptible individuals. The drug should therefore be with- drawn if a skin eruption, dizziness or chill occur ; it should not be administered in large doses or over a long period of time unless repeated leukocyte and differential counts are made at regular intervals. Dosage. — From 0.3 to 0.4 Gm. (5 to 6 grains), most con- veniently in the form of tablets, a single dose usually sufficing for twenty-four hours. Aminopyrine-Abbott. — A brand of aminopyrine-U. S. P. Manufactured by Abbott Laboratories, North Chicago, 111. Aminopyrine-Merck. — A brand of aminopyrine-U. S. P. Prepared by Merck & Co., Rahway, N. J. Pyramidon. — A brand of aminopyrine-U. S. P. Manufactured by the Winthrop Chemical Co., Inc., New York. U. S. patent expired. U. S. trademark. Elixir of Pyramidon: Each 4 cc. (one fluidrachm) contains pyramidon, 0.162 Gm. (2^ grains) in a menstruum containing alcohol 20 per cent. Pyramidon Tablets, ij^ grains. Pyramidon Tablets, 5 grains. PYRETHRUM OINTMENT 347 PYRETHRUM OINTMENT.— An ointment containing, an extract from powdered pyrethrum flowers (Chrysanthemum cinerariae folium). The extract is obtained by treating pow- dered pyrethrum flowers with a hydrocarbon oil of the kero- sene type; this extract is then incorporated into an ointment base composed of hydrous wool fat, petrolatum and paraffin. The finished ointment contains 27 per cent of the active extract (representing 0.75 per cent of pyrethrins I and II) and 73 per cent of ointment base. Actions and Uses. — Pyrethrum ointment-Upsher Smith has been shown to be an effective agent in the treatment of scabies. Based on the (as yet unpublished) investigation of Sweitzer and Tedder the claim is made that the ointment penetrates the burrows and kills both the mites and the eggs and that except in rare instances it does not produce dermatitis with resultant exfoliation. Sweitzer and Tedder reported four cases of allergic sensitivity to the active substance in a series of 618 patients treated. Dosage. — The ointment is applied to the entire body follow- ing a thorough cleansing with soap and water. Further appli- cations are made on at least three or four successive days. In most cases it is necessary to continue the treatment for a period of from five to seven days, and in obstinate cases the use of the ointment may be required for a longer time. The ointment should not be used on patients who are sensitive to pyrethrum flowers. Manufactured by the Upsher Smith Company, Minneapolis. No U. S. patent or trademark. Pyrethrum ointment is an unctuous, yellowish green mass. Place 5 Gm. of pyrethrum ointment in a suitable flask, add 25 cc. of half-normal potassium hydroxide alcoholic solution and an equal volume of water, and heat the mixture under a reflux condenser for five minutes. The alcohol is removed by evaporation, the mixture cooled and allowed to separate. Remove the liquid by decantation, add sufficient barium chloride solution, thoroughly mix and allow to separate. To the mixture add 1 cc. of sulfuric acid to remove the excess of barium salt. To about 5 cc. of the filtrate add an equal volume of mercuric sulfate solution: an immediate pink color develops which deepens on standing, finally changing to a green coloration with the development of a turbidity or a precipitate {monocarboxylic acid). Determine the pyrethrin content by the procedure (with slight modi- fication) described by Seil in "Soap" in May 1934; the combined pyrethrin content (pyrethrins I and II) is not less than 0.7S per cent nor more than 1 per cent. QUINIDINE Quinidine is obtained from cinchona bark as a by-product in the manufacture of quinine, to which it is closely related, being a stereoisomer of quinine. Actions and Uses. — Quinidine, like quinine, is a protoplasm poison. It affects protozoa more than bacteria but less power- fully than quinine. At one time it was used, to some extent, as a substitute for quinine because it was then much the cheaper 348 NEW AND NONOFFICIAL REMEDIES preparation. It has the antimalarial action of quinine, and may be tolerated by some patients who have an idiosyncrasy to quinine. Quinidine acts upon the heart in such a manner as to bring about cessation of fibrillation of the auricles in a certain pro- portion of instances. Quinidine and other cinchona alkaloids are the only drugs known to have this specific effect. The pharmacology of the drug has been extensively investigated It has been shown that quinidine increases the refractory period of the auricular muscle and decreases its irritability and the rate of conductivity. Its chief action is upon the cardiac muscle. In ordinary doses the heart is slowed and the auriculo-ventricular conduction time is lengthened. Quinidine is used to restore the normal rhythm of the heart in cases of auricular fibrillation. This has been brought about in approximately 50 per cent of the reported cases in which the drug has been used. It is apparently most efficacious in the cases of fibrillation of short duration or of the paroxysmal type. It may also stop fibrillation of several years' duration. It is least effective in cases of fibrillation with marked cardiac insuf- ficiency. Quinidine is not without some unpleasant and even dangerous effects. Some patients appear much more susceptible to its intoxication than others. The untoward symptoms brought about by its use in these patients are nausea, vomiting, con- vulsions, palpitation, headache, faintness and flushing. In most cases following the administration of the drug, the pulse increases in rapidity before the normal rhythm is established. In some cases the effect of the drug is restricted to this altera- tion of rhythm. In a few instances, such serious results as rapid idioventricular rhythms (ventricular tachycardia) have been initiated during the course of therapy. Toxic effects may appear after the establishment of a normal rhythm. Some cases have been reported in which sudden death occurred a short time after the drug had been stopped. The drug is rapidly eliminated and it appears that no cumulative effect can take place. It has no known permanent effect. Dosage. — Quinidine is generally administered as quinidine sul- fate. Commonly 0,2 Gm, (3 grains) of quinidine sulfate is given as a preliminary dose and is repeated after two hours to determine the patient's susceptibility to the drug. If there are no symptoms following this preliminary dose, therapeutic admin- istration is begun on the following day when from 0.2 Gm, to 0,4 Gm. (3 to 6 grains) is given from three to five times daily, for one to three days. As a rule, if the establishment of the normal rhythm can be effected, the change occurs after from one to three days' treatment. The maximum dose per day advised by most authors is from 1 to 2 Gm. (15-30 grains). If toxic symptoms occur, the administration of the drug should be discontinued. QUINIDINE 349 QUINIDINE. — Quinidina. — An alkaloid, C20H24O2N2+ 2H2O, obtained from the bark of various species of Cinchona. Actions and Uses. — See preceding article, Quinidine. Dosage. — See preceding article, Quinidine. Quinidine occurs in white crystals or as an amorphous, white powder; odorless; taste, intensely bitter and persistent; efflorescent in dry air. Quinidine is very slightly soluble in water; soluble in alcohol and ether; freely soluble in chloroform; very slightly soluble in petroleum benzin. The saturated aqueous solution of quinidine is alkaline to litmus and its alcoholic solution is dextrorotatory. A solution of quinidine in diluted sulfuric acid (1 in 1,000) shows a strong blue fluorescence. Quinidine loses its water of hydration at 100 C The dried alkaloid melts at about 168 C. Add a few drops of bromine water to 10 cc. of an aqueous solution of quinidine (1 in 1,000), prepared with just sufficient diluted sulfuric acid to produce complete solution, and follow with ammonia water in slight excess. The liquid acquires an emerald-green color. Dissolve about 0.1 Gm. of quinidine in 15 cc. of hot water contain- ing a few drops of diluted sulfuric acid; cool the solution; add 1 cc. of silver nitrate solution and stir the mixture with a glass rod. A white, crystalline precipitate forms after a short interval (distinction from many other alkaloids). Dissolve about 0.1 Gm. of quinidine in 10 cc. of warm water, con- taining a slight excess of diluted hydrochloric acid; add an excess of potassium iodide solution and agitate: an orange yellow, crystalline precipitate forms after an interval {distinction from quinine). Dissolve 0.5 Gm. of quinidine in 15 cc. of boiling distilled water, with just enough sulfuric acid to form a solution neutral to litmus paper, and add 5 cc. of potassium iodide solution. Agitate the mix- ture gently; cool _ it to 15 C., and keep it at this temperature for one hour, with occasional stirring: a white precipitate is formed {differ- ence from quinine). Filter out the precipitate and add 2 drops of ammonia water to the filtrate: not more than a slight turbidity results (limit of other cinchona alkaloids). Care must be taken to have the liquid perfectly neutral after the addition of the potassium iodide solution; if slightly acid, very dilute ammonia water must be added, drop by drop, with constant stirring until exact neutrality to litmus is attained. A solution of about 0.1 Gm. of quinidine in 5 cc. of sulfuric acid is not darker than pale yellow (organic impurities). Incinerate about 1 Gm, of quinidine, accurately weighed: the ash does not exceed 0.1 per cent. Dry about 1 Gm. of quinidine, accurately weighed, to constant weight at 100 C.: the loss does not exceed 11 per cent. Quinidine-Mallinckrodt. — A brand of quinidine-N. N. R. Mallinckrodt Chemical Works, St. Louis, distributor. No U. S. patent or trademark. Quinidine-Merck. — A brand of quinidine-N. N. R. Manufactured by Merck & Co., Inc., Rahway, N. J. No U. S. patent or trademark. QUINIDINE SULFATE.— "A sulfate of an alkaloid obtained from cinchona."- [/. vS. P. For standards see the U. S. Pharmacopeia under Quinidinae Sulfas. 350 NEW AND NONOFFICIAL REMEDIES Actions and Uses. — See preceding article, Quinidine. Dosage. — See preceding article, Quinidine. Quinidine sulfate may be administered in the form of cachets, capsules, pills or tablets. Quinidine Sulphate (Davies & Rose). — A brand of qui- nidine sulphate. Manufactured by Davies, Rose & Co., Ltd., Boston. Tablets Quinidine Sulphate 3 Gm. Davies & Rose. Quinidine SuLPHAXE-Merck. — A brand of quinidine sul- phate-U. S. P. Manufactured by Merck & Co., Rahway, N. J. QUININE DERIVATIVES The action of quinine is essentially the same in all its com- pounds. The official salts have the disadvantage of the bitter taste, and of producing a local action on the stomach and other tissues. To obviate these difficulties, insoluble compounds like the alkaloid or the tannate have been used, since these pass the mouth and stomach without offending the taste or disturbing the stomach. The same object is obtained more or less com- pletely in a number of synthetic compounds in which the quinine radical is combined with other radicals, such as those of car- bonic acid, to form insoluble, and therefore tasteless, esters. In the intestines these esters are broken up more or less rapidly into the alkaloid quinine and the other components. The rapid- ity with which this decomposition occurs will determine to a large extent the intensity of the therapeutic effect and the liability to produce cinchonism. Some of the esters also contain other therapeutically active radicals (phenetidin, salicyl, etc.). When liberated these pro- duce their characteristic effects ; but it is doubtful whether the combinations of several therapeutically active radicals in fixed proportions are superior to simple mixtures of the ingredients. QUININE.— "An alkaloid obtained from cinchona." U.S. P. For standards see the U. S. Pharmacopeia under Quinina. QUININE SULFATE.— For standards see the U. S. Pharmacopeia under Quininae Sulfas. Coco-Quinine: Each 100 cc. contains quinine sulfate, 2.19 Gm. (10 grains per fiuidounce), suspended in a syrup flavored with chocolate, yerba santa and vanillin, and containing sodium benzoate, 0.18 Gm. per 100 cc. and alcohol, 4 per cent. Prepared by Eli Lilly & Co., Indianapolis. U. S. trademark 174,144. RESORCIN COMPOUNDS 351 QUININE ETHYLCARBONATE. — Euquinine. — For standards see the U. S. Pharmacopeia under Quininae Aethyl- carbonas. Actions and Uses. — Quinine ethylcarbonate is used in place of quinine sulfate and similar soluble quinine salts when a practically tasteless quinine compound is preferred. Dosage. — The same as that of quinine sulfate. Quinine Ethyl Carbonate-Mallinckrodt. — A brand of quinine ethyl carbonate-U. S. P. Manufactured by Mallinckrodt Chemical Works, St. Louis. Quinine Ethyl Carbonate-Merck. — A brand of quinine ethyl carbonate-U. S. P. Manufactured by Merck & Co., Rahway, N. J. RESORCIN COMPOUNDS RESORCINOL MONOACETATE. — Resorcin Acetate, ;«-Hydroxyphenyl Acetate. — wi-Acetyloxyphenol CeHiCGH). (OOCCH3). The monoacetic ester of resorcinol. Actions and Uses. — The action of resorcinol monoacetate is similar to that of resorcinol, but milder and more lasting because of the gradual liberation of resorcinol. Resorcinol monoacetate is used in the treatment of acne, sycosis and chilblains, and particularly in the treatment of alopecia and seborrhea. Dosage. — Resorcinol monoacetate is applied in ointments of from 5 to 20 per cent and in acetone solution. For scalp lotions, alcoholic solutions of from 3 to 5 per cent are used. Resorcinol monoacetate is a viscous, lemon yellow liquid, boiling under ordinary pressure at 283 C. with decomposition. It is soluble in alcohol, acetone and most organic solvents; sparingly soluble in water. It has a faint characteristic odor and burning taste. Resorcinol monoacetate, at a pressure of 10 mm., distils completely between 150 and 153 C. Dissolve 10 cc. resorcinol monoacetate in 20 cc. benzene and shake with 100 cc. of distilled water containing methyl orange solution: not more than 0.5 cc. tenth-normal alkali is required to neutralize the free acidity. Euresol. — A brand of resorcinol monoacetate. — N. N. R. Manufactured by E. Bilhuber, Inc., Jersey City, N. J. (Bilhuber-Knoll Corporation, Jersey City, N. J., distributor). No U. S. patent. U. S. trademark 88,894. Euresol pro Capillis: Euresol perfumed to render it suitable for scalp lotions. Resorcinol Monoacetate-Eastman Kodak Co. — A brand of resorcinol monoacetate-N. N. R. Manufactured by the Eastman Kodak Co., Rochester, N. Y. No U. S. patent or trademark. 352 NEW AND NONOFFICIAL REMEDIES RHUS PREPARATIONS IVYOL POISON IVY EXTRACT.— A solution in olive oil of an irritant or vesicant oil extracted from the fresh leaves of poison ivy (Rhus toxicodendron). Actions and Uses. — Ivyol Poison Ivy Extract is used to relieve the symptoms of the dermatitis produced through con- tact with poison ivy. Dosage. — In cases of average susceptibility, the contents oi one syringe (0.55 to 0.6 cc.) intramuscularly at daily intervals for four doses or until relieved. In cases of unusual suscep tibility, from 0.2 to 0.35 cc, increased or not as indicated. Manufactured by Sharp & Dohme, Philadelphia and Baltimore. U. S patent 1,559,340 (Oct. 27, 1925; expires, 1942). U. S. trademark applied for. Ivyol Poison Ivy Extract: Miniature syringes each containing 0.7 cc. o^ ivyol poison ivy extract. The fresh leaves of Rhus toxicodendron are extracted with purified petroleum benzin. The resulting extract is filtered through paper and decolorized by agitation with fuller's earth. The decolorized extract is concentrated in vacuo to one-tenth its original volume; the concentrated extract is allowed to evaporate spontaneously to dryness; and the residue dissolved in sterile olive oil in the proportion of one part of the extract to 1,000 parts of oil, and 2 per cent of camphor is added as a preservative. IVYOL-POISON OAK EXTRACT-MULFORD. — A solution in olive oil of an irritant or vesicant oil extracted from the fresh leaves of poison oak (Rhus diver siloba) . Actions and Uses. — Ivyol-poison oak extract is used to relieve the symptoms of the dermatitis produced through contact with poison oak. Dosage. — In cases of average susceptibility, 0.7 cc. intra- muscularly at daily intervals for four doses or until relieved. In cases of unusual susceptibility, from 0.2 to 0.35 cc. increased or not as indicated. Manufactured by Sharp & Dohme, Philadelphia and Baltimore. U. S. patent 1,559,340 (Oct. 27, 1925; expires, 1942). U. S. trademark applied for. lyyol-Poison Oak Extract: Miniature syringes each containing 0.7 cc. of ivyol-poison oak extract, which permits administration of not more than 0.6 cc. The fresh leaves of Rhus diversiloba are extracted with purified petroleum benzin. The resulting extract is filtered through paper and decolorized by agitation with fullers' earth. The decolorized extract is concentrated in vacuo to one-tenth its original volume; the concentrated extract is allowed to evaporate spontaneously to dryness; and the residue dissolved in sterile olive oil in the proportion of one part of the extract to 1,000 parts of oil, and 2 per cent of camphor added as a preservative. POISON IVY EXTRACT-LEDERLE (IN ALMOND OIL). — A solution in almond oil of a substance extracted from the fresh leaves of poison ivy {Rhus toxicodendron). Actions and Uses. — Poison ivy extract-Lederle (in almond oil) is used to relieve the symptoms of the dermatitis pro- duced through contact with Rhus toxicodendron. There is RHUS PREPARATIONS 353 evidence indicating that the product is useful in prophylaxis of this dermatitis. Dosage. — One cubic centimeter injected intramuscularly at intervals of from twenty-four to forty-eight hours. For prophylaxis, it is suggested that two injections of 1 cc. each be given at a two week interval. Manufactured by the Lederle Laboratories, Inc., Pearl River, N. Y. No U. S. patent or trademark. Poison Ivy Extract-Lederle (in Almond OH) 1 cc. : Syringes contain- ing 1 cc. of poison ivy extract-Lederle (in almond oil). Freshly gathered mature leaves of Rhus toxicodendron are macerated with acetone. The resulting extract is decolorized and dehydrated and then concentrated until the content of solid matter becomes 13 per cent. Five parts of this liquid are added to 95 parts of sterile almond oil containing 0.5 per cent of chorobutanol and this liquid is filtered. POISON OAK EXTRACT-LEDERLE (IN ALMOND OIL). — A solution in almond oil of a substance extracted from the fresh leaves of poison oak (Rhus diversiloha). Actions and Uses. — Poison oak extract-Lederle (in almond oil) is used to relieve the symptoms of the dermatitis produced through contact with poison oak. Dosage. — One cubic centimeter injected intramuscularly at intervals of from twenty-four to forty-eight hours. Manufactured by the Lederle Laboratories, Inc., Pearl River, N. Y. No U. S. patent or trademark. Poison Oak Extract-Lederle (in Almond OH) 1 cc: Syringes contain- ing 1 cc. of poison oak extract-Lederle (in almond oil). Freshly gathered mature leaves of Rhus diversiloba are macerated with acetone. The resulting extract is decolorized and dehydrated and then concentrated until the content of solid matter becomes 13 per cent. Five parts of this liquid are added to 95 parts of sterile almond oil containing 0.5 per cent of chorobutanol and this liquid is filtered. RHUS TOX. ANTIGEN-STRICKLER.— A solution of a substance extracted from the fresh leaves of Rhus toxico- dendron; it contains 0.4 Gm. of procaine hydrochloride in each 100 cc. Actions and Uses. — Rhus tox. antigen-Strickler is used to determine sensitiveness to Rhus toxicodendron, and to relieve the symptoms of the dermatitis produced through contact with the plant. Dosage. — To determine sensitiveness to Rhus toxicodendron, 0.1 cc. of rhus tox. dermal test is injected intradermally. For treatment, three doses of from 0.5 to 1.5 cc. injected intra- muscularly are given at twenty-four hour intervals. Manufactured by the Mulford Colloid Laboratories, Philadelphia. No U. S. patent or trademark. Rhus Tox. Antigen-Strickler: Packages of four 1 cc. vials, each cc. containing 0.0075 Gm. of substance dissolved in 40 per cent alcohol. Rhus Tox. Dermal Test: Packages of a 1 cc. vial, each cc. containing 0.0125 Gm. of substance dissolved in a menstruum composed of dextrose, 354 NEW AND NONOFFICIAL REMEDIES 15 per cent; alcohol, 10 per cent, and water, 75 per cent (accompanied by a vial of rhus venenata dermal test). Freshly gathered leaves of Rhus toxicodendron are extracted with absolute alcohol; the alcohol is removed, the residue is extracted with chloroform to remove the chlorophyll, and then treated with zinc sul- fate; sodium phosphate is then added to precipitate the zinc as zinc phosphate; the precipitate is then collected and dried. The precipitate is extracted successively with ether, amyl alcohol and dimethyl carbinol in an extraction apparatus, the extractions evaporated and the residual extract dried at a low temperature. RHUS VENENATA ANTIGEN-STRICKLER. — A solution of a substance extracted from the fresh leaves of Rhus venenata; it contains 0.4 Gm. of procaine hydrochloride in each 100 cc. Actions and Uses. — Rhus venenata antigen-Strickler is used to determine sensitiveness to Rhus venenata, and to relieve the symptoms of the dermatitis produced through contact with the plant. Dosage. — To determine sensitiveness to Rhus venenata, 0.1 cc. of rhus venenata dermal test is injected intradermally. For treatment, three doses of from 0.5 to 1.5 cc. injected intra- muscularly are given at twenty-four hour intervals. Manufactured by the Mulford Colloid Laboratories, Philadelphia. No U. S. patent or trademark. Rhus Venenata Antigen-Strickler: Packages of four 1 cc. vials, each cc. containing 0.0075 Gm. of substance dissolved in 40 per cent alcohol. Rhus Venenata Dermal Test: Packages of a 1 cc. vial, each cc. con- taining 0.0125 Gm. of substance dissolved in a menstruum composed of dextrose, 15 per cent; alcohol, 10 per cent, and water, 75 per cent (accompanied by a vial of rhus tox. dermal test). Freshly gathered leaves of Rlius venenata are extracted with absolute alcohol; the alcohol is removed, the residue is extracted with chloroform to remove the chlorophyll and then treated with zinc sulfate; sodium phosphate is then added to precipitate the zinc as zinc phosphate; the precipitate is then collected and dried. The precipitate is extracted successively with ether, amyl alcohol and dimethylethyl carbinol in an extraction apparatus, the extractions evaporated and the residual extract dried at a low temperature. SALICYLIC ACID COMPOUNDS To avoid the disagreeable taste and gastric symptoms of salicylates, esters and similar compounds have been intro- duced, which are more or less insoluble, so that the salicyl radical is liberated only in the intestine or after absorption into the blood. These compounds have little, or no direct action on the stomach. Notwithstanding this, nausea and vomiting are frequently induced, probably owing to action on the central nervous system. In practice, these compounds are not superior to sodium salicylate, which does not produce direct gastric irritation when properly guarded by a bicar- bonate. The taste of these compounds is much less objectionable than that of the simpler salicylate salts, but this advantage scarcely balances their high cost. SALICYLIC ACID COMPOUNDS 355 The alkyl esters (methyl saHcylate type) are absorbed readily from the skin and are therefore better for external use than simpler salicylates. The acyl derivatives (acetylsalicylic acid type) possess a higher analgesic and antipyretic action and have therefore a special field. The salols contain active phenols which adapt them to intestinal antisepsis. Salicylic acid compounds may be arranged under four types : 1. Compounds formed by replacing the hydrogen (H) of the hydroxyl group (OH) in salicylic acid, by acyl radicals. To this type belong acetylsalicylic acid (aspirin) C6H40.(COCH3). COOH and novaspirn. 2. Compounds formed by replacing' hydrogen (H) of the carboxyl group (COOH) in salicylic acid by alkyl radi- cals: methyl salicylate, C6H4.0H.COO(CH3), and the cor- responding ethyl salicylate, methoxymethyl salicylate (mesotan), monoglycol salicylate (spirosal), and methyl benzoyl salicylate (benzosalin). Of these, ethyl salicylate, ethyl salicylate car- bonate (sal-ethyl carbonate), mesotan and spirosal are described in N. N. R. 3. Compounds formed by replacing the hydrogen (H) of the carboxyl group (COOH) in salicylic acid by phenol rad- icals: phenyl salicylate (salol), CoH4.0H.COO(C6Hb), and the corresponding betanaphthyl salicylate, and acetparamidophenyl salicylate (phenetsal). Of these, betanaphthyl saHcylate and phenetsal are described in N. N. R. 4. Salicylic compounds in which the salicylic action is sub- ordinate. Those described in N. N. R are : mercuric salicylate and santyl. EQUIVALENTS OF 100 PARTS OF VARIOUS SALICYLIC ACID DERIVA- TI\-ES IN TERMS OF SALICYLIC ACID AND SODIUM salicylate: Equivalent Parts Equivalent Parts of Sodium 1 00 Parts of of Salicylic Acid Salicylate Salicylic acid 100 116 Sodium salicylate 86 100 Acetylsalicylic acid 11 89 Sal-Ethyl carbonate 11 89 Novaspirin 62 72 Acid Derivatives of Salicylic Acid (Acetylsalicylic Acid Type) These are employed in rheumatic conditions, and especially as analgesics and antipyretics in colds, neuralgias, etc. Their analgesic effects surpass those of sodium salicylate, with less danger of local irritation. The promiscuous use of acetyl- salicylic acid (aspirin) by the laity, especially for the relief 356 NEW AND NONOFFICIAL REMEDIES of headache, has frequently led to cases of rather severe poi- soning, the chief symptoms being edema of the lips, tongue, eyelids, nose or of the entire face ; also urticarial rashes, vertigo, nausea and sometimes cyanosis. Some persons are especially susceptible to acetylsalicylic acid and these symptoms are usually ascribed to an idiosj^ncrasy. ACETYLSALICYLIC ACID.— Aspirin.— "When dried to constant weight over sulfuric acid, contains not less than 99.5 per cent of HC7H4O0C2H3O2." U. S. P. For standards see the U. S. Pharmacopeia under Acidum Acetylsalicylicum. Actions and Uses. — See preceding article. Acid Derivatives of Salicylic Acid (Acetylsalicylic Acid Type). Dosage. — From 0.3 to 1 Gm. (5 to 15 grains), repeated once in three hours until symptoms of salicylism (ringing in the ears, etc.) are noted. It may be administered in the form of a powder, wafers, or capsules. If prescribed as a powder, this may be administered by dissolving it in sweetened water, or by placing it on the tongue, and taking a swallow of water. The powder should be dispensed in wax paper. Acetylsalicylic Acid-Heyden. — A brand of acetylsalicylic acid-U. S. P. Prepared by Heyden Chemical Corporation, New York. Acetylsalicylic Acid-Mallinckrodt. — A brand of acetyl- salicylic acid-U. S. P. Manufactured by Mallinckrodt Chemical Works, St. Louis. Acetylsalicylic Acid-Merck. — A brand of acetylsalicylic acid-U. S. P. Manufactured by Merck & Co., Rahway, N. J. Acetylsalicylic Acid (Aspirin) -Monsanto. — A brand of acetylsalicylic acid-U. S. P. Manufactured by Monsanto Chemical Works, St. Louis. NOVASPIRIN. — Salicitrin. — Methylene-Citrylsalicylic Acid. CH2.C00(GH4.C00H) I O.CHa c o I CO CH2COO(C6H4.COOH).— A compound of anhydromethylenecitric acid and salicylic acid. Actions and Uses. — See preceding article. Acid Derivatives of Salicylic Acid (Acetylsalicylic Acid Type). Dosage. — 1 Gm. (15 grains), several times daily. Manufactured by Winthrop Chemical Company, Inc., New York City. U. S. patent 858,142 (June 25, 1907; expired). U. S. trademark 62,613. SALICYLIC ACID COMPOUNDS 357 Novaspirin Tablets, 5 grains. Novaspirin is a grayish-white odorless, crystalline powder, permanent in the air, having a faint acidulous taste. It is almost insoluble in water; soluble in alcohol; less soluble in ether or chloroform. On heating novaspirin with caustic alkalis, salicylate is formed, and on adding diluted acid to the alkaline solution, crystals of salicylic acid are separated. On long standing in the presence of water or more quickly with alkalis, novaspirin is split into its components. When heated in a dry test tube novaspirin melts, and at higher temperatures formaldehyde and salicylic acid are liberated. The salicylic acid sub- limes and is deposited on the cooler portions of the tube. Novaspirin when decomposed yields 62 per cent of salicylic acid. After drying over sulfuric acid to constant weight, novaspirin melts at from 153 to 154 C. A saturated, aqueous solution of novaspirin (prepared with- out heat) does not produce a violet color with ferric chloride solution. Incinerate 1 Gm. of novaspirin: not more than 0.1 per cent of ash remains. Dry 1 Gm. of novaspirin over sulfuric acid: the loss in weight is not more than 5 per cent. Alkyl Derivatives of Salicylic Acid (Methyl- Salicylate Type) These act somewhat more slowly, but otherwise as efficiently as sodium salicylate. They are for the most part saponified in the intestines, but some may be absorbed unchanged. They have not the disagreeable taste, but frequently they cause some- what more local irritation. They are also quite well absorbed from the skin, and may, therefore, be applied externally, usually dissolved in olive oil. Methyl salicylate is official in the U. S. Pharmacopeia. ETHYL SALICYLATE.— Aethylis Salicylas.— C6H4OH. C.O.O.(C2H5). — The salicylic acid ester of ethyl alcohol anal- ogous to methyl salicylate (oil of wintergreen). Actions and Uses. — Ethyl salicylate has the same action as methyl salicylate, but is said to be less irritant and less toxic. Dosage. — From 0.3 to 0.6 cc. (5 to 10 minims) three or four times a day. It is a transparent, colorless, volatile liquid, possessing a pleasant characteristic odor and taste. Its specific gravity is 1.132 at 20 C. and it boils at from 230 to 232 C. It is insoluble in water, but soluble in alcohol. Sal-Ethyl.— A brand of ethyl salicylate-N. N. R. Manufactured by Parke, Davis & Co., Detroit. No U. S. patent. U. S. trademark 92,115. Sal-Ethyl Capsules, 5 minims. MESOTAN. — Salmester.— C6H40H.CO.O.(CH2.0.CH3).— Methyloxymethyl salicylate, an ester of salicylic acid, analogous to methyl salicylate. Actions and Uses. — Mesotan is an active counterirritant, used especially in rheumatic conditions, similarly to the local application of methyl salicylate. It is more irritant than the latter, and lacks its odor. It is absorbed from the skin, but 358 NEW AND NONOFFICIAL REMEDIES its action is predominantly local, relieving pain and swelling. It is not an efficient means for producing the systemic actions of salicylates. Dosage. — For application mesotan is diluted with 1 to 4 parts of olive oil or cotton seed oil, and is painted over the affected area usually twice daily. Friction should not be used, and dressings, if any are necessary, should be light and permeable. The site of application should be changed, if possible, after each treatment; or the area may be rested for two days after four days of treatment. Manufactured by Winthrop Chemical Co., Inc., New York. U, S patent No. 706,018 (Aug. 5, 1902; expired), U. S. trademark No 39,017. Mesotan is a clear, yellowish, faintly aromatic, oily fluid, specifit gravity 1.2 at 15 C. and boiling at about 162 C. It is but slightly soluble in water, but readily soluble in the usual organic^ solvents and miscible with oils in all proportions. Above 100 C. it is decom- posed, yielding salicylic acid, formaldehyde and methyl alcohol, and it is likewise decomposed to a certain extent by moisture in the air. The aqueous solution of mesotan gives a violet color with ferric chloride and, after heating or exposure to moisture, it responds to the usual tests for formaldehyde. Concentrated sulfuric acid colors it red. Mesotan should be kept in a cool place and preserved dry in well- stoppered bottles. SAL-ETHYL CARBONATE.— The carbonic acid ester of ethyl salicylate. — Salicvlic ethyl ester carbonate. — 0:C (OC6H4.COOQH5)2. Actions and Uses. — Sal-ethyl carbonate provides the anti- pyretic and analgesic effects of the salicylates. It is relatively insoluble in water and in the acid secretions of the stomach, whereby the disagreeable taste and local gastric symptoms of the soluble salicylates are practically avoided. For cases requir- ing a rapid analgesic and antipyretic effect rather than salicylate saturation, tablets sal-ethyl carbonate with aminopyrine are supplied; but it should be recalled that aminopyrine may pro- duce dangerous granulocytopenia in occasional individuals. Dosage. — Sal-ethyl carbonate and tablets sal-ethyl carbonate with aminopyrine may be given in dosages ranging from 0.3 to 1 Gm. (5 to 15 grains), three or four times daily, according to the individual requirements. Manufactured by Parke, Davis & Co., Detroit. No U. S. patent. U. S. trademark 92,115. Compressed Tablets Sal-Ethyl Carbonate 5 grs. Compressed Tablets Sal-Ethyl Carbonate with Aminopyrine: Each tab- let contains sal-ethyl carbonate 0.23 Gm. (3J4 grains) and aminopyrine 0.1 Gm. (IJ^ grains). Compressed Tablets Sal-Ethyl Carbonate with Phenacetin: Each tablet contains sal-ethyl carbonate 0.23 Gm. (3J/2 grains) and phenacetin (acetophenetidin-U. S. P.) 0.1 Gm. (1^ grains). Tablet Triturates Sal-Ethyl Carbonate 1 gr. Sal-ethyl carbonate occurs as white, odorless and tasteless crystals. It is almost insoluble in water and diluted hydrochloric acid. It is slightly soluble in ether and alcohol but readily soluble in chloroform and acetone. It melts between 96 and 99 C. SALICYLIC ACID COMPOUNDS 359 Transfer about 2 Gm. of sal-ethyl carbonate to a test tube, add 5 cc. of half normal alcoholic potassium hydroxide and heat on the steam bath for five minutes: the product dissolves, and the formation of a pre- cipitate follows; cool, decant the supernatant liquid, add 6 per cent acetic acid to the precipitate; it effervesces; add an equal volume of water to the decanted liquid: a colorless oil separates, having the odor of ethyl salicylate. Transfer about 1 Gm. of sal-ethyl carbonate to an Erlenmeyer flask, add 20 cc. of normal sodiurn hydroxide, 20 cc. of alco- hol and boil under a reflux condenser for thirty minutes; cool, acidify the solution by addition of diluted sulfuric acid; extract the solution with 20 cc. of ether, filter the ether, evaporate to dryness: the residue responds to qualitative tests for salicylic acid. Dissolve about 0.5 Gm. of sal-ethyl carbonate in 10 cc. of sulfuric acid: the solution remains colorless for five minutes (readily carboniz- able substances). Transfer about 0.5 Gm. of sal-ethyl_ carbonate to a test tube, add 10 cc. of water and a few drops of ferric chloride solu- tion: no blue color develops (salicylic acid). Transfer about 1 Gm. of sal-ethyl carbonate, accurately weighed, to an Erlenmeyer flask, add 40 cc. of half-normal alcoholic potassium hydroxide, boil under a reflux condenser on the steam bath for three hours, wash the condenser and add the washings to the flask, remove the alcohol by evaporating to about one-third the volume, adding 50 cc. of water and evaporating to about 15 cc, transfer the solution to a 250 cc. volumetric flask, make up to volume by addition of water. Transfer a 25 cc. aliquot to an Erlenmeyer flask and test the solution according to the method for total salicylate described in the A. O. A. C. Manual, third edition, page 446, Iodine Method, paragraph 24: the weight of the tetraiodophenylene quinone multiplied by 0.5208 and by the aliquot factor is equivalent to not less tnan 98.5 per cent nor more than 100.5 per cent of the sample taken. Transfer about 1 Gm. of sal-ethyl carbonate, accurately weighed, to a tared weighing bottle; heat in an oven at 100 C. for one hour; cool in a desiccator and weigh: the loss in weight is not greater than 1 per cent. Transfer about 0.5 Gm. of sal-ethyl carbonate, accurately weighed, to a platinum dish and ignite: the ash is not more than 0.2 per cent. SPIROSAL. — Alonoglycol-Salicylate. — Glysal. — CeHiGH CO.O.(CH2.CH2.0H). — The salicylic acid ester of monoglycol. Actions and Uses. — See preceding article, Acid Derivative of Salicylic Acid. When spirosal is applied to the skin from about one-fifth to one-sixth of the amount used is absorbed. Usually it causes very little irritation even when rubbed in thoroughly. Dosage. — It is used undiluted or mixed with from 2 to 3 parts of alcohol or in a mixture with olive oil, 1 to 8, or in ointments with equal parts by weight of petrolatum or lard. Manufactured by Winthrop Chemical Company, Inc. U. S. patent 794,982 (July 18, 1905; expired). U. S. trademark 62,856. Spirosal is an almost odorless and colorless oily fluid, with a boiling- point of from 169 to 170 C. at 12 mm. pressure. It is easily soluble in alcohol, ether, chloroform and benzol and soluble in about 110 parts of water and 8 parts of olive oil. When 0.5 Gm. spirosal is saponified with 5 cc. sodium hydroxide solution by slight warming, the clear fluid diluted with water and acidified with dilute sulfuric acid, fine crystalline needles of salicylic acid are formed, which, after being extracted with ether and the latter then _ evaporated, can be identified by the melting point and ferric chloride reaction. The saturated aqueous solution obtained by shaking 1 cc. of spirosal with 50 cc. of water gives a filtrate, which becomes intensely violet on addition of ferric chloride, but should not be changed by barium nitrate or silver nitrate solution. Five-tenths Gm. of spirosal when added to 2 cc. of concentrated sulfuric acid should give a light yellow and not a brownish color; 0.3 Gm., if incinerated on platinum foil, should not leave any weighable residue. 360 NEW AND NONOFFICIAL REMEDIES Phenol Derivatives of Salicylic Acid (Salol Type) Phenol derivatives of salicylic acid of the salol type are used mainly as intestinal antiseptics. Phenyl salicylate (salol) is official. BETANAPHTHYL SALICYLATE. — See Naphthol Compounds. PHENETSAL.— See Phenetidin Derivatives. Salicylic Compounds in Which the Salicylate Action Is Subordinate MERCURIC SALICYLATE.— See Alercuric Compounds. SANTYL.— See Sandalwood Oil Derivatives. SANDALWOOD OIL DERIVATIVES The oil of sandalwood is eliminated chiefly by the kidneys and is a fairly effective urinary antiseptic, although it is inferior to methenamine in acid urines. It is used particularly in sub- acute or chronic urethritis and cystitis. The oil, at times, is disturbing to the stomach, and medicinal doses may cause irritation of the bladder with dysuria and pain in the kidney region and urethra. The new derivatives of santal oil are generally less irritating than the oil itself. ARHEOL (Astier). — Santalol. — A sesquiterpenic alcohol, the chief constituent of sandalwood oil. Arehol (Astier) con- tains not less than 95 per cent of santalol. Actions and Uses. — The action of arehol (Astier) is the same as that of santalol. It is used in urethritis, cystitis and vesical catarrh, especially from gonorrhea. Dosage. — From 0.4 to 0.6 Gm. (6 to 10 grains). Arehol (Astier) is marketed only in pearls containing 0.2 Gm. (3 grains) of which from 9 to 12 pearls are to be taken daily. Manufactured by Dr. P. Astier Laboratories, Paris and Gallia Labora- tories, Inc., New York. No U. S. patent. U. S. trademark 72,513. Arheol (Astier) Pearls: Arheol pearls, 0.2 Gm. (3 grains). Arheol (Astier) is a colorless, oily liquid; specific gravity about 0.968 at 15 C. It is insoluble in water but soluble in alcohol. It boils under 11 mm. pressure at 169 C, and under ordinary pres- sure at about 300 C. SANTYL. — Santalolis Salicylas. — Salicylic Ester of Santalol.— Santalyl Salicylate.— C6H4OH.COO (C15H23). — The salicylic acid ester of santalol. SCOPOLAMINE 361 Actions and Uses. — It is said that santyl passes the stomach unchanged but is slowly split up in the intestines into its con- stituents, santalol and salicylic acid. Santyl is claimed to have the same actions as sandalwood oil, except that because of the slow liberation of santalol, it produces less irritation of the gastro-intestinal tract or of the kidneys and urinary passages, and no unpleasant odor or eructations. It is claimed to be useful in the same manner as santal oil for gonorrheal urethritis. Dosage. — 1.5 cc. (24 minims) usually given in 4 capsules of 0.4 cc. (6 minims) each, three times a day. It is incompatible with alkalis and with the usual incompatibles of the sandal- wood oil and of salicylates. Manufactured by E. Bilhuber, Inc., Jersey City, -N. J. (Bilhuber-Knoll Corporation, Jersey City, N. J., distributor). U. S. patent 862,858 (Aur. 6, 1907; expired) by license from The Chemical Foundation, Inc. U. S. trademark 61,255. Santyl Capsules, 6 minims. According to the German patent the neutral esters of sandalwood oil are produced by heating the oil with the respective acid anhydrides and subsequent purification of the product. Santyl is a yellowish oil with only a faint balsamic odor and taste: specific gravity, 1.07 at 15 C; it boils under 20 mm. pressure at 121 C. to 126.6 C, with partial decomposition. It is insoluble in water, but soluble in about 10 parts of alcohol. Santyl should possess the physical constants given above. On saponi- fication with alcoholic sodium hydroxide it should yield approximately 40 per cent of salicylic acid and 60 per cent of santalol. SCOPOLAMINE SCOPOLAMINE HYDROBROMIDE.— Hyoscine Hydrobromide. — "The hydrobromide of levorotatory scopo- lamine obtained from plants of the Solanaceae." U. S. P. For standards see the U. S. Pharmacopeia under Scopo- laminae Hydrobromidum. Actions and Uses. — It is used mainly as a sedative in Psy- chiatry and Surgery and also locally as a mydriatic in cases which display an idiosyncrasy toward atropine. Its peripheral (but not its central) action is similar to that of atropine but its effects are more transient. SCOPOLAMINE STABLE-ROCHE. — Scopomannit.— An aqueous solution of pure scopolamine hydrobromide, pro- tected against decomposition by the addition of 10 per cent of mannite. Actions, Uses and Dosage. — The same as those of scopo- lamine hydrobromide-U. S. P. Ampules Scopolamine Stable-Roche, V^oo grain, 1 cc. Each ampule contains 1.2 cc. (1 cc. contains 0.0003 Gm. of scopolamine hydrobromide). Ampules Scopolamine Stable-Roche, Vioo grain, 1 cc: Each ampule con- tains 1.2 cc. (1 cc. contains 0.0006 Gm. of scopolamine hydrobromide). Manufactured by Hofifmann-LaRoche, Inc., Nutley, N. J. No U. S. patent. German patent 266,415. U. S. trademark 103,288 and 103,289. 362 NEW AND NONOFFICIAL REMEDIES Scopolamine stable-Roche is prepared from freshly manufactured scopolamine hydrobromide having an optical activity of — 26.0" for the sodium line (determined in an aqueous solution containing the equivalent of 4.5 Gm. of anhydrous scopolamine hydrobromide in 100 cc. at a temperature of 15 C. in a 100 millimeter tube) and a melting point of 195 C. by dissolving in an aqueous 10 per cent solution of mannite. That scopolamine stable-Roche contains all of its scopolamine in an undecomposed state may be determined by comparing its action with that of a freshly prepared solution of scopolamine hydrobromide. For this purpose the manufacturers recommend the method of Langer, in which the frog heart is stopped by muscarine, or, better, by pilocarpine, and the systolic beat is reestablished by the addition of scopolamine, which is antagonistic to both muscarine and pilocarpine. SERUMS AND VACCINES Under this heading are described in the following pages agents of a complex biologic nature which are used in the treatment and diagnosis of disease and which depend for their action on various phases and relations of immunity. Federal Regulations. — The urgent need for control of many of these potent and, in some cases, dangerous products has been partly met by a federal law entitled "An act to regulate the sale of viruses, serums, toxins, and analogous products in the District of Columbia, to regulate interstate traffic in said articles and for other purposes." Under this law the importation, exportation or interstate sale of these products is expressly forbidden unless the manufacturer holds a license from the Secretary of the Treasury. It is to be noted that the protection of the federal law is of avail only in the case of prophylactic and therapeutic prepa- rations which are shipped for interstate sale. Only products which are licensed for import, export or interstate sale and which have not been found to conflict with the rules of the Council will be found listed here. In purchasing the products for use, preference should be given to those which have been kept continually at a low temperature. Dating of Biologic Products. — The federal law requires that each package of biologic products be marked with an expira- tion date, "the date beyond which the contents cannot be expected beyond reasonable doubt to yield their specific result." The regulations framed under this law, as outlined below, prescribe for each class of product how long after date of manufacture or issue this expiration date may be; but the temperature at which the product is kept after leav- ing the manufacturer's hands cannot be controlled. The tem- perature on the shelves of the supply house or drug store during storage is fully as important as the time of such storage, and physicians would do well to secure their biologic products from stocks which are shown by actual continuous thermometer records to have been kept in cold storage. This is particularly applicable to the more rapidly deteriorating products, such as smallpox vaccine, rabies vaccine, diphtheria toxoid antipneumococcic serum, and antimeningococcic serum. SERUMS AND VACCINES 363 Official potency standards have been established, or official potency tests are made at the National Institute of Health prior to the release of each lot, for the following products : botulinus antitoxin, diphtheria antitoxin, B. histolyticus antitoxin, B. odematiens antitoxin, staphylococcus antitoxin, tetanus antitoxin, scarlet fever streptococcus antitoxin, perfringens antitoxin, vibrion septique antitoxin, diphtheria toxin-antitoxin mixture, diphtheria toxoid, antidysenteric serum, antimeningococcic serum, antipneu- mococcic serum, bacterial vaccines prepared from paratyphoid bacillus A, paratyphoid bacillus B, and typhoid bacillus, diph- theria toxin for the Schick test and scarlet fever streptococcus toxin for the Dick test and for immunization. For these products the dating of each lot is based on the last test for potency, that is, the date of manufacture is taken as the last date of satisfactorily passing a potency test. For all other biologic products, the testing for potency is on a less satisfactory basis, and the date of manufacture is counted as the date of removal from the animal in case of animal products, or the date of cessation of growth in the case of other products. For the purpose of determining the expiration date, the date of issue may be used instead of the date of manufacture, provided the product has been kept between the date of manufacture and the date of issue not longer than the following periods, at the corresponding temperature: twenty- four months con- stantly below C. ; or twelve months constantly below 5 C, or six months constantly below 10 C. ; or three months con- stantly below 15 C. Added Preservatives. — The safeguarding of serums, vaccines, etc., against bacterial contamination requires the addition of some antiseptic. In the preservation of serums which are used in larger volumes, the amount and character of the preservative are more important matters. The most commonly used anti- septics are cresol (0.4 per cent), phenol (0.5 per cent), glycerin, and organic mercury compounds. Immunity Reactions. — Immunity, in its broadest medical sense, means resistance to disease or harm. To attempt a more precise definition would give emphasis to certain theo- ries or parts of the subject to the exclusion of others. The science of immunology, however, is concerned chiefly with the specific reactions which occur after a preparation containing the micro-organisms of an infectious disease or a complex substance similar to the products of micro-organisms is intro- duced within the body. In general, these reactions are specific; for instance, diphtheria toxin stimulates the body to produce an antitoxin which combines with no other toxin save that produced by the diphtheria bacillus. The reactions of immunity may act either to prevent dis- ease or to cure it, or to distinguish one disease from another. Accordingly, the products enumerated in this section may be used in prophylaxis, in treatment, or in diagnosis. Immunity 364 NEW AND NONOFFICIAL REMEDIES may be natural to the individual or it may be acquired. That which is called into play by the use of these products is, of course, acquired immunity. There is a further classification of acquired immunity into passive and active forms. In active immunity, the agents which actually perform the protective work are created within the body. In passive immunity, these agents are introduced ready formed from without. This gives us a basis for the classification of the therapeutic products. Those of the first class, the serums, and the antitoxins, which are derived from the serums, are intended to produce passive immunity ; they are "antibodies," which directly antagonize the invading bac- teria and toxins. The other great class of immunity products is called "anti- gens" because they are administered in the hope that their presence in the body will stimulate the production of anti- bodies. This active immunity, formed by the introduction of anti- gens is, in general, slower in appearance but more lasting than the passive immunity caused by the introduction of foreign antibodies. It must be remembered also that the antigen is of the same nature as the organism causing the disease which is to be combated, and that in using" antigens we are calling on the cells and fluids of the individual to produce their own protecting substances. To the class of antigens belong bacterial and viral vaccines, tuberculins, toxins, and toxoids. These antigens and antibodies are of unknown chemical composition and of high molecular weight, and even when soluble, are not usually absorbed, without change, from the gastro-intestinal tract. Hence, they must be administered by the intracutaneous, subcutaneous, intramuscular, intraspinal, or intravenous route in order to reach tissues not directly accessible. The use of serums and serum preparations is sometimes followed by certain manifestations which are discussed under Normal Horse Serum. These are due to sensitivity of the individual to horse serum and in certain cases may be avoided by the use of serums from the bovine species or from sheep or goats. I. Non-Immune Serums NORMAL HORSE SERUM.— Serum Equinum.— The serum of the blood of the normal horse obtained in a sterile manner and passed through a Berkefeld filter. Actions and Uses. — Though not a specific immunity prod- uct, normal horse serum is classed commonly with the other serums. It is claimed that it is used with success in hemor- rhagic conditions, to increase the coagulability of the blood. ^ The injection of horse serum is followed in certain indi- viduals by more or less pronounced symptoms of anaphylactic SERUMS AND VACCINES 365 shock. In its mildest form, this appears as an urticarial erup- tion on the skin or an edematous swelling of the mucous membranes. In more severe cases, there may be a fall of temperature, increased rapidity of pulse, quickened and diffi- cult respiration, cyanosis, and occasionally convulsions. In rare cases, the attack comes on with great suddenness and may terminate fatally. These cases of sudden death occur especially in asthmatics and in patients who are naturally hypersensitive to horse serum. Ordinary serum disease mani- fests itself by milder but similar symptoms which appear from a few days to one or two weeks after the injection of the serum. In addition to the eruptions which are urticarial or scarlatiniform, joint pains and swelling of the joints some- times occur. If horse serum is applied liberally to a burn or an open wound on a patient who is sensitive, there is danger of a severe if not a fatal reaction. Before administering horse serum or a preparation containing it to a patient, whether topically, intracutaneously, subcutaneously, or intravenously, the physician should obtain a history of the patient as regards serum admin- istration. Even if the history shows absence of previous symp- toms of allergy or of previous serum administration, the safest procedure is to make a test of sensitiveness by injection of not more than 0.05 cc. of a 1 in 10 dilution of the serum in the skin of the forearm or the instillation of a drop of the same dilution into the conjunctival sac. No patient showing sensi- tiveness should be given the serum without previous desensitiza- tion. Most cases of serum reaction have occurred after the use of antitoxic serums ; but emphasis should be laid on the fact that these symptoms are not caused by antitoxin, but are due to hypersusceptibility to the proteins of horse serum in which it is contained. Atropine and epinephrine hypodermically, should be used for the severer manifestations of serum reactions. The Gilliland Laboratories, Inc., Marietta, Pa. Normal Horse Scrum. — Marketed in syringes each containing 10 cc; also in vials containing 10, 25, SO or 100 cc. as ordered. Lederle Laboratories, Inc., Pearl River, N. Y. Normal Horse-Serum. — Marketed in a special syringe containing 10 cc, with sterile needle. Normal Horse Serum (1:10 Dilution) for the Conjunctival Test. — Normal horse serum one part, diluted with physiological solution of sodium chloride nine parts, and containing 0.45 per cent chlorobutanol. Marketed in packages of one vial with dropper outfit. To determine hypersensitiveness to the proteins of horse serum, one drop is placed in the conjunctival sac. Eli Lilly & Co., Indianapolis. Normal Horse Serum. — The serum of the blood of the normal horse obtained in a sterile manner and passed through a Berkefeld filter. Marketed in packages of one syringe containing 10 cc; also in packages of one vial containing 20 cc. 366 NEW AND NONOFFICIAL REMEDIES Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Normal Horse Serum. — Marketed in packages of one 10 cc. syringe; in packages of one 20 cc. syringe; in packages of one 50 cc. double ended vial. Normal Horse Serum Without Preservative. — Marketed in packages of one vial containing 100 cc. The National Drug Co., Philadelphia. Normal Horse Serum. — Marketed in packages of one syringe contain- ing 10 cc. ; in packages of two syringes each containing 10 cc; in packages of one vial containing 25 cc. ; in packages of one double ended vial containing 50 cc. Also marketed in packages of one 10 cc. vial, and in packages of one 100 cc. double ended vial, complete with intravenous outfit. One cc. of a 10 per cent dilution is included with each package for determining sensitivity of the patient by scratch or intradermal test. Parke, Davis and Company, Detroit. Normal Horse Serum-P. D. and Co. — Marketed in packages containing one 10 cc. syringe container; in packages containing one 10 cc. rubber- stoppered bulb; in packages containing one 30 cc. rubber-capped bulb, and in packages containing one 1 cc. rubber-stoppered vial. E. R. Squibb & Sons, New York. Normal Horse Serum. — Marketed in packages of one syringe containing 10 cc; also in vials of 20 cc and 50 cc United States Standard Products Company, Woodworth, Wis. Normal Horse Serum. — Marketed in packages of one vial containing 10 cc. The serum is preserved with 0.4 per cent of orthocresol. II. Antibodies Used for Prophylactic or Therapeutic Purposes Antibodies are usually directed against the toxins or solu- ble products of bacteria or against the bacteria themselves. All the antibodies enumerated below^ are formed in the blood serum of the larger domestic animals by active immunization ; that is, by injecting the animal with an antigen. The animal is then bled to furnish the serum, which afterward may be purified, in the case of the antitoxins and some immune serums, to remove as many inactive substances as possible, leaving the antitoxin in a concentrated form. ANTITOXINS The antitoxins are among the most useful of the antibodies. As the name implies, they antagonize toxins. Though toxins may be secreted by plants other than the bacteria and by some animals, e. g., the snake, the typical toxins are the soluble poisons produced by diphtheria and tetanus bacilli. Diphtheria and tetanus are dangerous diseases almost entirely on account of the action of these toxins, and conversely, their prevention or cure, when the organisms have once gained entrance to the body, depends on the work of the particular antitoxin. Though the presence of the toxin stimulates the body to produce antitoxin, this active immunity may not be SERUMS AND VACCINES 367 enough to save life; and, at any rate, assistance by the injection of antitoxin, ready made in the blood serum of another animal, hastens the cure or may prevent the disease. In some cases, eruptions occur after injection of antitoxin, rarely swelling and pain in the joints. In other cases, more severe symptoms have been observed and in a few instances sudden death has occurred. These conditions are due, not to the antitoxin but to the horse serum in which it is contained. (See Normal Horse Serum.) ANAEROBIC ANTITOXIN.— An antitoxic serum pre- pared by immunizing animals against the anaerobic bacteria found in gangrenous wounds. Actions and Uses. — Evidence has been published to indicate that the use of anaerobic toxin preparations may be of value in the treatment of gas gangrene. Cutter Laboratories, Berkeley, Calif. Polyanaerobic Antitoxin, Prophylactic (Tetanus-Gas Gangrene Anti- toxin.). — An antitoxic serum prepared by immunizing horses with the toxins of B. tetani (CI. tetani), B. perfringens (CI. zvelchii), and' Vibrion septique (CI. oedematismaligni). The animals are usually immunized with individual toxins and the resulting antiserums are con- centrated by a modified Banzhaf method and mixed in proper proportions. Unitage of the tetanus antitoxin, Welch bacillus antitoxin and Vibrion septique antitoxin is determined according to the method prescribed by the National Institute of Health. The product is marketed in syringes and in vials containing 1,500 units of Tetanus antitoxin, 2,000 units of B. welchii antitoxin, 2,000 units of Vibrion septique antitoxin. Dosage. — The usual prophylactic dose is the contents of one syringe. Cases in which considerable time has elapsed since the injury or in which the wound is particularly liable to severe infection may require a larger initial dose. In those cases in which the wound is badly lacerated, or which are badly soiled, the dose should be repeated in seven days. Polyanaerobic Antitoxin, Therapeutic (Gas Gangrene Antitoxin). — ^An antitoxic serum prepared by immunizing horses with the toxins of B. welchii (CI. welchii), Vibrion septique (CI. oedematismaligni) , B. oede- matiens (CI. oedematiens) and B. sordelli (CI. oedematoides). The animals are usually immunized with individual toxins and the resulting antiserums are concentrated by a modified Banzhaf method and mixed in proper proportions. Welch bacillus antitoxin, vibrion septique and oedematiens antitoxin are standardized according to the method described by the National Institute of Health. B. sordellii antitoxin is standard- ized by determining the number of guinea-pig minimal lethal doses of each toxin against which the unit volume of the antitoxin will protect. The product is marketed in bottles containing 10,000 units of B. welchii antitoxin, 10,000 units of Vibrion septique antitoxin, 500 units of B. oedematiens and enough B. sordellii antitoxin to neutralize 50,000 or more guinea-pig minimal lethal doses of their respective toxins. Dosage. — The initial therapeutic dose is the contents of one bottle, repeated at intervals of from six to twelve hours as required. In the early stages of treatment the antitoxin should be given intravenously if possible. Lederle Laboratories, Inc., Pearl River, N. Y. Tetanus Gas-Gangrene Antitoxin, "Globulin-Lederle-Modified." — A polyvalent antitoxin prepared by immunizing horses against the toxins of B. tetani (CI. tetani), B. perfringens (CI. perfringens) and Vibrion septique (CI. oedematis-maligni). The toxins are individually prepared 368 NEW AND NONOFFICIAL REMEDIES in suitable broth mediums grown aerobically after inoculation with anaerobically grown cultures. Some horses are immunized with injec- tions of but one toxin, while others are immunized against several, simultaneously. When trial bleeding tests indicate that horses have achieved a suitabe antitoxic potency, aseptic bleedings of plasma are made. This product differs from tetanus-gas-gangrene antitoxin refined and concentrated-Lederle chiefly in the method of refinement. Accord- ing to the manufacturer, the process of refinement is based essentially on a controlled method of selective digestion of the proteins of the immune horse blood with pepsin. As a result of this process, up to 90 per cent of the coagulable protein may be digested, a small portion is precipitated, and the remainder, a pseudoglobulin fraction, is purified first by ordinary filtration and then by ultrafiltration and dialysis. The resultant solution is sterilized and standardized the same as antitoxin solutions obtained by the usual "salting out" methods. Tests for the content of tetanus antitoxin, perfringens antitoxin and Vibrion septique antitoxin are made according to the methods described by the National Institute of Health. The product is marketed in packages of one syringe containing one prophylactic dose and one vial containing one prophylactic dose, stated to represent tetanus antitoxin 1,500 units, perfringens anti- toxin 2,000 units and Vibrion septique 2,000 units. Dosage. — Prophylactic: the contents of one syringe or vial within twelve hours of the injury. If there is still further danger of infection, this may be repeated in five to seven days. Gas-Gangrene Antitoxin (Polyvalent) without Tetanus Antitoxin, "Globulin-Lederle-Modified." — A polyvalent antitoxin prepared by immunizing horses against the toxins of B. perfringens (CI. perfringens), Vibrion septique (CI. oedematis maligni), B. oedematiens (CI. oede- matiens), B. sordellii (CI. sordellii) and B. histolyticus (CI. hist olyti cum ) . The toxins are individually prepared in suitable broth mediums grown aerobically after inoculation with anaerobically grown cultures. Some horses are immunized with injections of but one toxin, while others are immunized against several, simultaneously. When a potent antitoxic serum (as indicated by potency tests applied to trial bleedings) is obtained, aseptic bleedings of plasma are made. This product differs from gas-gangrene antitoxin (polyvalent) without tetanus antitoxin-Lederle chiefly in the method of refinement. The process of refinement is based essentially on a controlled method of selective digestion of the proteins of the immune horse blood with pepsin; as a result of this process, up to 90 per cent of the coagulable protein may be digested, a smaller portion is precipitated, and the remainder, a pseudoglobulin fraction, is purified first by ordinary filtration and then by ultrafiltration and dialysis. The resultant solution is sterilized and standardized the same as antitoxin solutions obtained by the usual "salting out" methods. Tests for the content of perfringens antitoxin and Vibrion septique antitoxin are made according to the method prescribed by the National Institute of Health. B. oedematiens (CI. oedematiens) antitoxin is tested according to the method prescribed by the Commission of Biological Standardization of the League of Nations in August 1934. The B. histolyticus (CI. his- tolyticum) and B. sordellii (CI. sordellii) antitoxins are tested for potency by injection into mice of serial dilutions of the antitoxin with definite amounts of the respective toxins, the M. L. D. of the toxins having previously been determined on mice. The unit of B. histolyticus (CI. histolyticum) is defined as that amount which will neutralize 100 M. L. D. of B. histolyticus (CI. histolyticum) toxin for a 20 Gm. mouse; the unit of B. sordellii (CI. sordellii) antitoxin is defined as that amount which will neutralize 1,000 M. L. D. of B. sordellii (CI. sordellii) toxin for a 20 Gm, mouse. The product is marketed in pack- ages of one vial containing one therapeutic dose, stated to represent perfringens antitoxin 10,000 units, Vibrion septique antitoxin, 10,000 units, oedematiens (Novyi) antitoxin 200 units, and sordellii antitoxin 200 units. Dosage. — Therapeutic: for tetanus and gas gangrene, an initial intra- venous injection of one to four minimum therapeutic doses; supple- mentary injections may be given in from four to six hours or as soon as they are indicated by the symptoms. SERUMS AND VACCINES 369 Eli Lilly and Company, Indianapolis. Gas Gangrene Antitoxin (Combined). — An antitoxic serum prepared by immunizing horses against the toxins of B. perfringens (CI. welchii) and Vibrion septique (CI. oedematismaligni). After the desired degree of potency is obtained, the horses are bled, the plasma separated and the serum prepared in a manner similar to that used for other antitoxic serums. The product is concentrated and refined by a method which is similar to that used for diphtheria antitoxin. Marketed in packages of one syringe containing 10,000 units of perfringens antitoxin and 10,000 units of Vibrion septique antitoxin. Dosage. — The contents of one syringe or more, preferably by intra- venous injection, repeated in from eight to twenty-four hours, as required. Tetanus-Gas-Gangrene Antitoxin (Combined). — An antitoxic serum pre- pared by immunizing horses against the toxins of B. tetani (CI. tetani) and B. perfringens (CI. welchii). As the desired degree of potency is obtained for the respective antitoxins, the horses are bled, the plasma is separated, and the serum is prepared in a manner similar to that used for other antitoxic serums. Marketed in packages of one syringe, con- taining 1,500 units of tetanus antitoxin and 4,000 units of perfringens antitoxin. Dosage. — The contents of one syringe, given intramuscularly as promptly as possible after injury and repeated in from five to seven days if further danger of infection is present. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Perfringens Antitoxin. — B. welchii Antitoxin. — Anti-Gas Gangrene Serum. — An antitoxic serum prepared by immunizing horses with gradu- ally increasing doses of the toxin of B. perfringens (CI. zvelchii). After the desired degree of potency is obtained, the horses are bled, the plasma is separated, and the serum is prepared in a manner similar to that used for other antitoxic serums. In the preparation of the concentrated product, a method is used which is similar to that used for concentrated diphtheria or tetanus antitoxin. The unitage is determined according to the method prescribed by the U. S. Public Health Service. The product is marketed in 50 cc. bottles of unconcentrated serum containing at least 200 units per cubic centimeter; and in 20 cc. syringes of concen- trated serum containing at least 500 units per cubic centimeter. Dosage. — For prophylaxis, 2,500 units; for treatment, initially from 4,000 to 10,000 units intramuscularly and 4,000 units intravenously, fol- lowed by 4,000 to 8,000 units intramuscularly at daily intervals as indicated. Tetanus Gas-Gangrene Antitoxin Mixed-Mulford. — An antitoxic serum prepared by immunizing horses with gradually increasing doses of the toxins of CI. tetani (B. tetani), CI. Welchii (B. perfringens), and CI. oedematis-maligni (Vibrion septique). After the desired degree of potency is obtained, the horses are bled, the plasma is separated and the serum is prepared in a manner similar to that used for other antitoxic serums. Marketed in packages of one ampule-vial and one syringe containing 1.500 units Clostridium tetani antitoxin, 2,000 units Clostridium Welchii antitoxin, and 2,000 units Clostridium oedematis-maligni antitoxin. Dosage. — For prophylaxis, the contents of one syringe or ampule injected subcutaneously in a single dose. To maintain the antitoxic titer of the blood, the dose is repeated on the third or fifth day. The National Drug Co., Philadelphia. Gas Gangrene Antitoxin Refined and Concentrated (CI. Perfringens — CI. Septique Antitoxin). — An antitoxic serum prepared by immunizing horses individually against the toxins of B. perfringens (CI. welchii) and Vibrion septique (CI. oedematismaligni). After the desired degree of potency is obtained, the horses are bled, the plasma is separated and the serum is prepared in a manner similar to that used for other antitoxic serums. The product is concentrated and refined by a method which is similar to that used for diphtheria antitoxin. The unit values of the 370 NEW AND NONOFFICIAL REMEDIES constituents are determined according to the method described by the National Institute of Health. Marketed in packages of one syringe containing 10,000 units of perfringens antitoxin and 10,000 units of vibrion septique antitoxin. Dosage. — The contents of one syringe, preferably by intravenous or intramuscular injection, repeated in from eight to twenty-four hours, as may be indicated by the effect of the antitoxin in the course of the infection. It is advisable to inject 5,000 units around the area of the wound, where possible, to neutralize the toxins produced at, or near, the site of the injury. Tetanus-Perfringens Antitoxin, Refined and Concentrated. — An anti- toxic serum prepared by i mm unizing horses individually against the toxins of B. tetani (CI. tetani), B. perfringens (CI. welchii) and Vibrion septique (CI. oedematismaligni) . After the desired degree of potency is obtained, the horses are bled, the plasma is separated and prepared in a manner similar to that used for other antitoxic serums. The product is concentrated and refined by a method which is similar to that used for diphtheria antitoxin. The unit values are determined according to the method described by_ the National Institute of Health. Marketed in packages of one syringe or one ampule-vial containing 1,500 units of tetanus antitoxin, 2,000 units of perfringens antitoxin and 2,000 units of vibrion septique antitoxin. A 1 cc. vial of a 1:10 dilution of anti- toxin is included with each package, for scratch or intradermal test, to determine sensitivity of the patient. Dosage. — For prophylaxis, the contents of one syringe, or ampule-vial, injected intramuscularly or, preferably, intravenously. Parke, Davis & Co., Detroit. Gas-Gangrene Antitoxin (Combined) Refined and Concentrated-P. D. & Co. — An antitoxic serum prepared from the toxins of B. perfringens (CI. welchii) and Vibrion septique (CI. oedematismaligni). Horses are immunized with the respective toxins separately. The resulting antitoxins are standardized, the units for each being those specified by the United States Public Health Service. The antitoxins are refined, concentrated and combined in such proportion that the quantity of the finished product in the marketed syringes contain 10,000 units of each antitoxin. Gas- gangrene antitoxin (combined) refined and concentrated-P. D. & Co. is proposed_ for therapeutic use against gas-gangrene infection caused by B. perfringens (CI. welchii) and Vibrion septique (CI. oedematismaligni). It is marketed in syringes containing 10,000 units of perfringens anti- toxin and 10,000 units of vibrion septique antitoxin; also marketed in vials contaiiiing 10,000 units of perfringens antitoxin and 10,000 units of vibrion septique antitoxin. Dosage. — The contents of one syringe, preferably by intravenous injec- tion, repeated in from eight to twenty-four hours if necessary, especially in acute peritonitis and obstruction of the small bowel. Tetanus-Gas-Gangrene Antitoxin (Combined) (Prophylactic) Refined and Concentrated-P. D. & Co. — An antitoxic serum prepared from the toxins of B. tetani (CI. tetani), B. perfringens (CI. welchii) and Vibrion septique (CI. oedematismaligni) . Horses are immunized with repeated Gradually increasing doses of tetanus toxin until the serum samples rom treated animals show, when tested according to standard methods, satisfactory antitoxin content. Regular bleedings are then obtained from the treated animals and the antiserums stored at a temperature below 5° C, after which they are chemically refined and concentrated. The antitoxins are tested and standardized, the units of each being those specified by the U. S. Public Health Service. Tetanus-gas-gangrene anti- toxin (combined) (prophylactic) refined aiid concentrated-P. D. & Co. is proposed for use as a prophylactic against tetanus and gas bacillus infections and is especially indicated iii the treatment _ contused and penetrating wounds contaminated with soil, sewage material or the con- tents of the patients' intestinal tract. It is marketed in packages of 1 syringe (Bio. 2025) and in rubber-diaphragm capped vial (Bio. 2023) each containing respectively, 1,500 units of tetanus antitoxin, 2,000 units of perfringens antitoxins and 2,000 units of vibrion septique antitoxin. Dosage. — The contents of one container injected subcutaneously or intramuscularly. Further prophylactic injections should be repeated at 24 to 48 hour intervals when exposure to gas bacilli is strongly suspected. SERUMS AND VACCINES 371 U. S. Standard Products Co., Woodworth, Wis. Polyanaerobic Antitoxin (Tetanus-Gas-Gangrene) Refined and Con- centrated (U. S. S. P. Co.). — An antitoxic serum prepared by immuniz- ing horses with the toxins of B. tetani (CI. tetani), B. perfringens (CI. welchii) and Vibrion septique (CI. oedematismaligni). When tests of trial bleedings indicate that the potency is sufficiently high, the horses are bled into anticoagulant and the plasma concentrated and refined by methods according to the Park-Banzhaf process. The unit values of the concentrates are determined according to the methods described by the National Institute of Health. It is marketed in packages of one syringe, one prophylactic dose, containing vibrion septique antitoxin, 2,000 units; tetanus antitoxin, 1,500 units; and B. perfringens (CI. welchii) anti- toxin, 1,000 units. Dosage. — For prophylaxis: The contents of one syringe injected sub- cutaneously or intramuscularly. BOTHROPS ANTITOXIN.— An antitoxic serum pre- pared by immunizing animals against the venom of the tropical American serpents of the genus Bothrops. Actions and Uses. — In animal tests the venom of certain snakes may be neutralized by the employment of a serum obtained from animals that have been injected with venom from a snake of the same family. Bothrops antitoxin is used to neutralize the venom injected by the bite inflicted by members of the genus Bothrops. Dosage. — The serum is administered intramuscularly or sub- cutaneously ; in cases seen late or in the presence of severe symptoms it may be administered intravenously. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Antivenin (Bothropic). — Tropical American Anti-Snake-Bite Serum. — An antitoxic serum prepared by injecting horses with venom from serpents of the genus Bothrops, especially of the "Fer-de-Lance" (Bothrops atrox). It is claimed to have neutralizing effect against the venom of the genus represented. The venom is extracted and promptly desiccated. It is dissolved in saline glycerin solution and injected sub- cutaneously into horses in fractional, gradually increasing doses until immunity has been established. The horses are bled and, after separation, the plasma is concentrated by a salting out process. Potency is deter- mined by tests on pigeons, the maximum amount of venom neutralized by 1 CO. of the serum being taken as the titer of the product; this quan- tity must neutralize at least 2 mg. of the venom when tested on pigeons, mice and rabbits. Marketed in syringes of 10 cc. (a single dose). BOTULINUS ANTITOXIN.— An antitoxic serum pre- pared by immunizing animals against two or more strains of the toxin of Clostridium botulinum. Actions and Uses. — For prophylaxis and treatment of botulism. Jensen-Salsbery Laboratories, Inc., Kansas City, Mo. Botulinus Antitoxin (Human)-Jensen-Salshery. — This antitoxin is pre- pared by the hyperimmunization of horses and cattle by continued and progressively increasing doses of botulinus toxin. It is prepared against two types of the toxin, namely, A and B. Each type is prepared in separate animals and the commercial product is prepared by mixing given quantities of each type so that each marketed package will contain 2,000 units each of type A and type B antitoxin, the unit of each being that established and distributed by the National Institute of Health. The 372 NEW AND' NONOFFICIAL REMEDIES animals are bled at specified intervals and the same technic is used in preparing the final product as is required by the National Institute of Health in the preparation of the antitoxins for which standards have been established. The product is not concentrated but consists of the whole serum as it is derived from the defibrinated blood by process of centrifugation and Berkefeld filtration. The preservative consists of a mixture of equal parts of refined tricresol and ether so that the final volume is 0.8 per cent of the combined preservative. It is marketed in packages of one vial containing 2,500 units each of type A and type B botulinus antitoxin. Dosage. — Prophylactic, subcutaneous injections of at least 2,000 units of bivalent antitoxin; curative, intravenous injection of at least 10,000 units of the bivalent antitoxin repeated as the nature of the case indicates. BOVINE TETANUS ANTITOXIN.— An antitoxin complying with the standards for tetanus antitoxin-U. S. P., except that it is made from the serum of cattle instead of from horse serum. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Tetanus Antitoxin (Boinne). — An antitoxin derived from the blood serum of cattle immunized against the toxin of B. tetani (CI. tetani). Marketed in packages of one syringe containing 1,500 units (one immuniz- ing dose). CROTALUS ANTITOXIN.— An antitoxic serum pre- pared by immunizing animals against the venom of snakes of the crotalus family. Actions and Uses. — Tests on animals show that the venom of certain snakes may be neutralized by the employment of a serum obtained from animals that have been injected with venom from a snake of the same family. Crotalus antitoxin is used to neutralize the venom injected by the bite inflicted by members of the crotalus family. Dosage. — The serum is administered intramuscularly or sub- cutaneously; in cases seen late or in the presence of severe symptoms it may be administered intravenously. Recent observations seem to show that there is great advantage in giving the serum in the vicinity of the bite. Use of the anti- toxin never should be allowed to replace first aid measures, especially local incision and suction. Perhaps 50 cc. of serum is as small an amount as is likely to prove beneficial. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Antivenin (Nearctic Crotalidae). — North American Anti-Snake-Bite Serum. — An antitoxic serum prepared by injecting horses with venoms from serpents of the North American species of the family Crotalidae (Rattle Snake, 75 per cent; Copperhead, 12^ per cent; and Water Moccasin, 12J^ per cent). It is claimed to have neutralizing effect against the venom of the species represented. The venom is extracted from the snakes and promptly desiccated. The mixture of the venoms is injected subcutaneously into horses in fractional doses until immunity is established. The animal is bled, and the plasma is concentrated by a salting out process. Marketed in syringes containing 10 cc. SERUMS AND VACCINES 373 DIPHTHERIA ANTITOXIN.— Purified Antidiphtheric Serum. — Concentrated Diphtheria Antitoxin. — Refined Diph- theria Antitoxin. — Antidiphtheric GlobuHns. — "Diphtheria Anti- toxin is a sterile aqueous solution of antitoxic substances obtained from the blood serum or plasma of a healthy animal of the genus Equus, which has been immunized against diph- theria toxin. After the serum or plasma from the immunized animal has been collected, the antitoxin-bearing globulins are separated from the other constituents of the serum or plasma and dissolved in freshly distilled water. Sodium chloride and a preservative are then added and the solution is filtered through a bacteria-excluding filter. Diphtheria Antitoxin has a potency of not less than 500 antitoxic units per cc." U. S. P. For standards see the U. S. Pharmacopeia under Antitoxinum Diphthericum. Lederle Laboratories, Inc., Pearl River, N. Y. Diphtheria Antitoxin, Globulin-Lederle-Modified. — This preparation differs from diphtheria antitoxin-U. S. P. chiefly in the method of refine- ment. The process of refinement is based essentially on a controlled method of selective digestion of the proteins of the immune horse blood with pepsin. As a result of this process, as much ai; 90 per cent of the coagulable protein may be digested, a smaller portion is precipitated, and the remainder, a pseudoglobulin fraction, is purified, first by ordinary filtration and then by ultrafiltration and dialysis. Diphtheria antitoxin, globulin-Lederle-modified, is marketed in single syringe packages repre- senting 1,000, 5,000, 10,000, 20,000 and 40,000 units of diphtheria anti- toxin, respectively. DIPHTHERIA ANTITOXIN, BOVINE. — An anti- toxin differing from diphtheria antitoxin-U. S. P. in that it is made from the serum of cattle instead of from horse serum and is less potent. Mulford Biological Laboratories, Sharp & Dohme, Inc., Philadelphia and Baltimore. Diphtheria Antitoxin (Bovine). — An antitoxin derived from the blood serum of cattle immunized against diphtheria toxin. Diphtheria anti- toxin (bovine) serves as an alternative to diphtheria antitoxin (equine) in the treatment of individuals giving a positive reaction to the ophthalmic test with diphtheria antitoxin prepared from horse serum. Marketed in packages of one 30 cc. ampule vial containing 5,000 units. ERYSIPELAS STREPTOCOCCUS ANTITOXIN.— An antitoxic serum prepared by immunizing animals against the toxin of the hemolytic streptococci of erysipelas. Actions and Uses. — Reports have been published which sug- gest that the injection of erysipelas streptococcus antitoxin favorably affects the course of erysipelas by lowering the tem- perature, decreasing leukocytosis, causing the lesions to fade, and relieving the symptoms of toxemia. Dosage. — There is no established dosage. Quantities recom- mended by various manufacturers vary from 12 cc. to 100 cc, to be repeated according to the influence or want of influence on the course of the infection. For intravenous injection, the unconcentrated serum is proposed; the concentrated serum, in smaller doses, is used either intravenously or intramuscularly. 374 NEW AND NONOFFICIAL REMEDIES Lederle Laboratories, Inc., Pearl River, N. Y. Erysipelas Streptococcus Antitoxin, Globulitv-Lederle-Modified. — An antitoxin prepared by immunizing horses through the injection of gradu- ally increasing doses of toxin produced by typical strains of streptococci isolated from erysipelas lesions, and by the well-known scarlet fever strain Dochez NY 5. This scarlet fever strain has been introduced because of its unusually potent and broadly valent antigenic quality which includes in a more potent form, characteristics also possessed by many "erysipelas strains." The process of refinement is based chiefly on a controlled method of selec- tive digestion of the proteins of the immune horse blood with pepsin. As a result of this process, up to 90 per cent of the coagulable protein may be digested, a smaller portion is precipitated, and the remainder, a pseudo- globulin fraction, is purified first by ordinary filtration and then by ultra- filtration and dialysis. The resultant solution is sterilized and subjected to the tests prescribed by the National Institute of Health, While anti- toxin processed in this manner is stated to produce fewer reactions than antitoxin processed by the usual "salting out" method, it is still a protein solution and all customary precautions should be taken to avoid or care for serum reactions. Erysipelas streptococcus antitoxin, globuIin-Lederle-modified, is admin- istered in early cases of moderate severity in one "basic dose" (the entire content of one syringe as marketed) intramuscularly, repeated if neces- ary at intervals of twenty-four hours until the erysipelatous blush dis- appears; in late and severely toxic cases, larger doses with a shorter interval between doses may be used. It is marketed in packages of one syringe containing one basic dose. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore, Erysipelas Streptococcus Antitoxin ( Concentrated) -Mulford. — This anti- toxic serum is prepared by injecting horses intradermally with strains pi hemolytic streptococci isolated by H. Amoss from human cases of erysip- elas lesions, bleeding the horses and when test bleedings show the serum to have reached the desired potency, separating the serum, sterilizing it, and preserving by the addition of 0.35 per cent of phenol. The product is then concentrated by a process which preserves both the antitoxic and antibacterial properties claimed to be in the original serum. Erysipelas streptococcus antitoxin (concentrated) -Mulford is standardized in terms of "protective units" (1 unit being one-tenth of the amount of erysipelas streptococcus antitoxin required to protect 66 per cent of the mice injected with one minimal fatal dose of a virulent culture of erysipelas streptococci). It is administered in doses of 20 cc, given intramuscu- larly, and repeated within twelve to twenty-four hours if indicated. Marketed in packages of one 10 cc. syringe containing 500,000 protective units. Parke, Davis & Co., Detroit. Erysipelas Streptococcus Antitoxin Refined and Concentrated-P. D. & Co. — This antitoxin is prepared by immunizing horses with toxin and cul- tures of streptococci isolated from erysipelas. The blood serum is with- drawn from the immunized animals and is concentrated and refined by methods similar to those used for other antitoxins. The neutralizing value of the antitoxin is demonstrated by mixing dilutions of the anti- toxin with erysipelas streptococcus toxin and injecting intradermally into the skin of humans susceptible to erysipelas. The product is claimed to possess antitoxic properties. It is marketed in packages of one piston syringe containing either 10 cc. or 20 cc. of the concentrated product. E. R. Squibb & Sons, New York. Erysipelas Streptococcus Antitoxin Co^icentrated-Squibb. — This anti- toxin is prepared according to the method of K. E. Birkhaug of the School of Medicine and Dentistry of the University of Rochester. It is obtained by immunizing horses by repeated injections of the toxic filtrate from a number of strains of hemolytic streptococci of erysipelas furnished by Birkhaug and the injection of living cultures of the strep- SERUMS AND VACCINES 375 tococci. The antitoxin thus obtained is concentrated by a modification of the Banzhaf method, preserved by the addition of 0.4 per cent of cresol, and standardized by determining its neutralizing power against a specific toxin furnished by the licensor. The product is marketed in packages of one syringe containing 10 cc. United States Standard Products Company, Woodworth, Wis. Erysipelas Streptococcus Antitoxin (Refined anid Concentrated) .— Prepared by immunizing horses with toxin and cultures of streptococci isolated from erysipelas cases. When tests of trial bleedings indicate that the potency is sufficiently high the horses are bled and the plasma concentrated and refined by methods similar to those used for other antitoxins. The product is preserved with 0.4 per cent cresol in a 50 per cent ether solution. Potency tests are carried out by making serial dilutions of the antitoxin with equal amounts of erysipelas toxin and determining the titer by the rabbit ear method which is a toxin neutral- ization test. Marketed in packages of one syringe containing approximately IS cc, the average initial therapeutic dose. MENINGOCOCCUS ANTITOXIN.— An antitoxin pre- pared by the immunization of animals to polyvalent filtrates of six to eight day hormone-broth cultures of the four Gordon groups of meningococcus, after the method of Ferry, Norton and Steele. Actions and Uses. — The published studies on the effect of the antitoxin in experimental meningococcic septicemia in guinea-pigs and rabbits, in experimental meningomyelitis in monkeys and in clinical epidemic meningitis in man suggest (1) that the symptomatology of the disease is attributable at least in part to the effects of a toxin produced by the organism and (2) that the clinical manifestations of the disease, its com- moner complications and its mortality rate may all be favorably affected by the timely and proper administration of the antitoxin. The antitoxin should be used only in specific infec- tions with the rnepingococcus, and the usual precautions con- cerning the administration of horse serum should be observed. Dosage. — Dependent on the condition of the patient, the degree of toxemia, the occurrence of complications, and whether child or adult, 20,000 to 30,000 units (60-100 cc.) in 120— 200 cc. of physiological solution of sodium chloride may be administered intravenously (injected slowly). This may be repeated daily if required. These doses (60-100 cc.) may be given intramuscularly, but it is (probably) a less effective route. Dependent on the same factors and also on the volume of spinal fluid withdrawn, 6,000—12,000 units (20-40 cc.) may be injected intraspinally or intracisternally. This procedure may be repeated daily if required. The usual case is said to require a total of from 50,000 to 100,000 units. Parke, Davis & Co., Detroit. Meningococcus Antitoxin-P. D. & Co. — An antitoxic serum prepared by immunizing horses to bacteria-free meningococcus toxin, preserved with 0.3 per cent of tricresol. The antitoxin is standardized by human skin tests, the skin test dose of meningococcus toxin being that which when injected intradermally into a susceptible individual will produce a local Z16 NEW AND NONOFFICIAL REMEDIES skin reaction at least 10 mm. in diameter. The unit of meningococus antitoxin is ten times that amount of the antitoxin which, when mixed with one skin test dose of meningococcus toxin, will produce a negative reaction or a reaction appreciably less than 10 mm. in diameter, provided the controlled toxin reaction is appreciably more than 10 mm. in diameter. The final product is standardized to contain not less than 350 units of meningococus antitoxin per cubic centimeter. It is marketed in packages of one vial having a diaphragm stopper at each end and containing 10 thousand units of antitoxin. SCARLET FEVER STREPTOCOCCUS ANTI- TOXIN. — An antitoxic serum prepared by immunizing animals against the toxin of the hemolytic streptococcus of scarlet fever. It is prepared (a) after the method of G. F. Dick and G. H. Dick by immunizing horses by injecting the soluble toxin of strains of hemolytic streptococci that have produced experi- mental scarlet fever in human beings and (6) by the method of A. R. Dochez in which horses are immunized against the specific scarlet fever organism by the localization of the living streptococci in a subcutaneous agar nodule in which the strep- tococci grow and stimulate the production of antitoxic and antibacterial substances. Certain modifications of these methods are employed by some producers. Scarlet fever streptococcus antitoxin is standardized in terms of units, according to the method prescribed by the U. S. Public Health Service, each unit being capable of neutralizing fifty skin test doses of toxin. Actions and Uses. — During recent years much evidence has accumulated to show that scarlet fever is caused by hemolytic streptococci and that the administration of a serum containing the antitoxin produced by these organisms favorably influences the course of scarlet fever. It is also believed that temporary immunity against scarlet fever may be established through the use of such a serum. The serum is also used to distinguish the rash of scarlet fever from other rashes by the production of a blanched area at the site of its intradermal injection. The Gilliland Laboratories, Inc., Marietta, Pa. Scarlet Fever Streptococcus Antitoxin (Refined and Concentrated). — It is prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. The serum is concentrated by the method employed in concentrating diphtheria antitoxin. Marketed in packages of one syringe containing 2,000 units (prophylactic dose), and in packages of one syringe containing 6,000 units (therapeutic dose). Lederle Laboratories, Inc., Pearl River, N. Y. Scarlet Fever Streptococcus Antitoxin-Globulin-Lederle-Modified. — It is prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. The process of refinement is based chiefly on a controlled method of selective digestion of the proteins of the immune horse blood with pepsin. As a result of this process, as much as 90 per cent of the coagulable protein may be digested, a smaller portion is precipitated, and the remainder, a pseudoglobulin fraction, is purified first by ordinary filtra- tion and then by ultrafiltration and dialysis. Marketed in packages of one syringe containing 2,000 units (prophylactic dose), and in packages of one syringe containing 6,000 units (therapeutic dose). SERUMS AND VACCINES ZTJ Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Scarlet Fever Streptococcus Antitoxin Concentrated. — It is prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. The serum is concentrated by the method employed in concentrating diph- theria antitoxin. Marketed in packages of one syringe containing 2,000 units (prophylactic dose) and in packages of one syringe containing 6,000 units (therapeutic dose) ; also marketed in single 1 cc. vial packages (for the diagnostic blanching test) containing sufficient scarlet fever antitoxin for five tests. The National Drug Co., Philadelphia. Scarlet Fever Streptococcus Antitoxin Refined and Concentrated- "National." — It is prepared by inoculating horses with scarlet fever strep- tococcus toxin and live virulent cultures of scarlet fever streptococci, under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. It is marketed in syringe packages of 2,000 units (prophylactic dose) ; in syringe packages of 6,000 units (therapeutic dose); A 1 cc. vial of a 1:10 dilution of antitoxin is included with each package, for scratch or intradermal test, to determine sensitivity of the patient; also marketed in single 1 cc. vial packages for the diagnostic blanching test (Schultz-Carlton reaction) containing suffi- cient scarlet fever streptococcus antitoxin for five tests. Parke, Davis & Co., Detroit. Scarlet Fever Streptococcus Antitoxin-P. D. & Co.— It is prepared by inoculating horses with scarlet fever streptococcus toxin under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. Marketed in packages of one syringe (prophy- lactic dose) containing 2,000 units; in packages of one syringe (thera- peutic dose) containing 6,000 units, and in single 1 cc. vials (for the diagnostic blanching test) containing sufficient scarlet fever antitoxin for five blanching tests. E. R. Squibb & Sons, New York. Scarlet Fever Streptococcus Antitoxin Concentrated. — It is prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires, 1942) by license of the Scarlet Fever Committee, Inc. The serum is concentrated by the Banzhaf method. Marketed in packages of one syringe containing 2,000 to 2,500 units (prophylactic dose) ; in pack- ages of one syringe containing 6,000 units (therapeutic dose) ; and in packages of 1 cc. vials (for the diagnostic blanching test) containing sufficient scarlet fever antitoxin for ten blanching tests. TETANUS ANTITOXIN.— Purified Antitetanic Serum. — Concentrated Tetanus Antitoxin. — Refined Tetanus Anti- toxin. — Antitetanic Globulins. — "Tetanus Antitoxin is a sterile aqueous solution of antitoxic substances obtained from the blood serum or plasma of a healthy animal of the genus Equus, which has been immunized against tetanus toxin. After the serum or plasma from the immunized animal has been collected, the antitoxin-bearing globulins are separated from the other constitutents of the serum or plasma and dis- solved in freshly distilled water. Sodium chloride and a preservative are then added and the solution is filtered through a bacteria-excluding filter. Tetanus antitoxin has a potency of not less than 300 antitoxic units per cc." U. S. P. For standards see the U. S, Pharmacopeia under Antitoxinurn Tetanicum, 378 NEW AND NONOFFICIAL REMEDIES Lederle Laboratories, Inc., Pearl River, N. Y. Tetanus Antitoxin, Glohnlin-Lederle-Modified. — This preparation differs from tetanus antitoxin-U. S. P. chiefly in the method of refinement. The process of refinement is based essentially on a controlled method of selective digestion of the proteins of the immune horse blood with pepsin. As a result of this process, as much as 90 per cent of the coagulablc protein may be digested, a smaller portion is precipitated, and the remainder, a pseudoglobulin fraction, is purified first by ordinary filtra- tion and then by ultrafiltration and dialysis. Tetanus antitoxin, globulin- Lederle-modified, is marketed in packages of one vial containing 1,500 units of antitoxin; in single syringe packages representing 1,500, 3,000, 5,000, 10,000, 20,000 and 40,000 units of tetanus antitoxin, respectively; and in packages of one cylinder containing 10,000 units of tetanus anti- toxin, for intraspinal administration. ANTIBACTERIAL SERUMS More complex in action than the antitoxins and much less satisfactory for therapeutic purposes are those antibodies which resist the bacteria themselves. This field of usefulness is open to much controversy, both theoretical and practical. ANTIANTHRAX SERUM.— Serum Antianthracicum. — A serum prepared by immunizing horses against virulent anthrax bacilli (Bacillus anthracis). Actions and Uses. — Good results have generally been reported from the use of the specific serum in human anthrax. Pro- tective antibodies can be demonstrated experimentally. Dosage. — Minimum of 50 cc. intramuscularly or intrave- nously. The serum should be used as early as possible and used freely, the dose being repeated several times a day in severe cases. Lederle Laboratories, Inc., Pearl River, N. Y. Antianthrax Serum. — Initial doses of from 100 to 200 cc. may be administered intramuscularly or intravenously, to be repeated in twenty- four hours if indicated. Marketed in packages containing one 50 cc. cylinder with intravenous outfit, bulb and sterile needle. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Antianthrax Serum-Mulford. — Marketed in packages of one syringe of 20 cc. ; in packages of one double ended vial of 50 cc. 100 cc. should be injected intravenously as the initial dose. Parke, Davis & Company, Detroit. Antianthrax Serum. — Marketed in syringes containing 50 cc. Initial dose of from 50 to 100 cc, injected intravenously, should be fol- lowed by further injection in six or more hours. It is well to test the sensitization of the patient to horse serum, prior to the first injection, by means of the cutaneous test, which will require about one-half hour. The drop of serum required for this test can be obtained directly from the syringe container of antianthrax serum. ANTIDYSENTERIC SERUM. — Serum Antidysen- tericum. — The serum (polyvalent) of horses immunized against the Shiga bacillus {Shigella dysenteriae, B. dysenteriae), its products of growth, and other types of the dysentery bacilli. SERUMS AND VACCINES 379 Actions and Uses. — A reduction in the mortality rate of bacillary dysentery through the use of some serums has been reported by some observers but not confirmed by all. It would seem that the best results may be ascribed to an antitoxic action in infections with the Shiga-Kruse type of bacillus. Infections with the Flexner, Harris or Hiss-Y strains, which are relatively poor in toxin production, have not been so favorably affected, though some bactericidal action is claimed. The most favorable results are observed in the early stage of the disease. The serum is required to show a high agglutinin titer for the various types of dysentery bacilli. Dosage. — From 20 to 100 cc, subcutaneously. Lederle Laboratories, Inc., Pearl River, N. Y. Antidysenteric Serum (Polyvalent). — From horses hyperimmunized against the Shiga toxin and the Shiga and Flexner types of dysentery bacilli. Marketed in vials containing 20 cc. Dosage. — For prophylaxis: 10 cc. injected subcutaneously. For treat- ment: an initial dose of from SO to 100 cc. (preferably injected intra- venously) and repeated at four-hour intervals as indicated by symptoms. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Antidysenteric Serum (Polyvalent). — From horses immunized against the Shiga, Flexner and Y strains of the dysentery bacillus. Marketed in packages of one syringe containing 20 cc. each; also in packages of one vial, containing 50 cc. each, with or without sterile needle and sterile rubber tubing for intravenous injection. Dosage. — Fifty to 100 cc, to be followed at eight hour intervals by doses of SO cc. until 400 cc. has been given. Prominent authorities recommend intravenous injection. Parke, Davis & Co., Detroit. Antidysenteric Serum. — From horses immunized against several strains of Shiga, Flexner and Hiss-Y types of dysentery bacilli. Marketed in packages of one vial, containing 20 cc. Dosage. — Ten cc. is suggested as prophylactic dose; therapeutic dose, 60 to 100 cc, preferably intravenously. ANTIMENINGOCOCCIC SERUM. — Antimeningococ- cus Serum. — Meningococcus Serum. — Meningitis Serum. — "Obtained from the blood of an animal of the genus Equiis immunized with cultures of the several types of meningococci (Neisseria intracellular is) which prevail in the United States." U. S. P. For standards see the U. S. Pharmacopeia under Serum Antimeningococcicum. Actions and Uses. — Greater success seems to have attended the use of serum directed against the meningococcus than has been the case with any other antibacterial serum. Each lot of the serum is required to be tested by agglutination and none is allowed to be sold which does not reach a reasonable titer against the several types of meningococci. Each lot is tested at the National Institute of Health prior to sale. 380 NEW AND NONOFFICIAL REMEDIES Dosage. — Average dose for adults, 30 cc. (1 fluid ounce) intraspinally as early as possible in the disease, repeated as indicated; for children, doses up to 20 or 30 cc. intraspinally depending upon the amount of spinal fluid that can be with- drawn and the amount of serum that can be administered with- out untoward symptoms. The serum should be introduced slowly by gravity after the removal of a corresponding amount of spinal fluid. Administration should be controlled by blood pressure readings, a drop of 10 mm. of mercury during the administration being the signal for withdrawal of the needle. In addition, up to 50 cc. for children and up to 100 cc. for adults may be administered intravenously in very early cases or in those cases accompanied by frank meningococcemia as demon- strated by positive blood cultures, or by hemorrhagic rash. The Gilliland Laboratories, Inc., Marietta, Pa. Antimeningococcic Serum. — Marketed in packages of one vial contain- ing 15 cc, with sterile needle, stylet and attachments for intraspinal administration; in packages of two vials each containing 15 cc. with sterile needle, stylet and attachments for intraspinal administration. Dosage. — The recommended intraspinal dosage for the treatment of epidemic cerebrospinal meningitis is from 5 to 15 cc. or more for a child, and 30 cc. or more for an adult. Lederle Laboratories, Inc., Pearl River, N. Y. Antimeningococcic Serum. — Marketed in cylinders containing, respec- tively, 15 and 30 cc, each with sterile needle and stylet. Dosage. — Usually 20 cc. intraspinally, though 30 cc. or more may some- times be given if a large amount of spinal fluid has been withdrawn and the serum runs in without difficulty. This dosage applies to all ages, though unusual care should be exercised in the case of young babies. This treatment is continued every 12 to 24 hours until the spinal fluid becomes clear or until meningococci can no longer be demonstrated in spinal fluid obtained from two successive punctures. Eli Lilly & Co., Indianapolis. Antimeningococcic Serum Concentrated, Lilly. — Refined and concen- trated by the Banzhaf method. Marketed in packages of one 10 cc. double ended vial with apparatus for intraspinal injection. Mulford Biological Laboratories, Sharp «& Dohme, Phila- delphia and Baltimore. Antimeningococcic Serum. — Marketed in double ended vials, each con- taining 15 cc. with sterilized rubber tubing and sterilized intraspinal needle and stylet for injections by the gravity method. Also marketed in one syringe containing 30 cc, with intraspinal and intravenous injection outfit. Dosage. — From 15 to 30 cc. or more at intervals of twenty-four hours. The National Drug Company, Philadelphia. Antimeningococcic Serum. — Marketed in packages of two 15 cc. double- end vials with apparatus for intraspinal injection; in packages of one 15 cc. cylinder with intraspinal needle; and in packages of one 30 cc. double-end vial, with special intravenous and intraspinal needles and gravity outfit. A 1 cc. vial of a 1: 10 dilution of serum is included with each package, for scratch or intradermal test, to determine sensi- tivity of the patient. SERUMS AND VACCINES 381 Parke, Davis & Company, Detroit. Antimeningococcic Serum: Marketed in packages of two syringes, with flexible connection, gravity tube and needle with stylet each con- taining 15 cc. ; also in packages of one syringe with needle and long flexible tube, suitable for intravenous injection either by pressure or gravity method, each containing 30 cc. Dosage. — From 30 to 150 cc, intravenously; from 15 to 30 cc. or more intraspinally. E. R. Squibb & Sons, New York. Antimeningococcic Serum. — Marketed in packages of two 15 cc. con- tainers in a gravity outfit with needle and trocar. United States Standard Products Company, Woodworth, Wis. Antimeningococcic Serum Polyvalent. — Marketed in packages of two double-ended vials, each containing 15 cc. with apparatus for intraspinal injection. Also marketed in packages of one double-ended vial contain- ing 30 cc. ANTIPNEUMOCOCCIC SERUMS Antipneumococcic serums are obtained from horses immunized by injection of virulent pneumococci (Diplococcus pneumoniae). Pneumococci of several serological types may cause lobar pneumonia. In addition to the fixed types I, II and III originally recognized, subdivisions of type II have been described. The previously heterogeneous group IV has been partially resolved into a number of serological types, about 30 now being recognized. If a definite diagnosis of acute lobar pneumonia is made within two days of the onset and rapid typing is not possible, treatment with antipneumococcic serum containing types I and II may be instituted without waiting to determine the pneumococcus type, but it should be realized that this treatment will be of no value in about half the cases. ANTIPNEUMOCOCCIC SERUM, TYPE I.— Anti- pneumococcus Serum, Type I. — Pneumonia Serum, Type I. — "Obtained from the blood of an animal of the genus Eqiius which has been immunized with cultures of a pneumococcus (Diplococcus pneumoniae) of a variety known as 'type I'." U. S. P. For standards see the U. S. Pharmacopeia under Serum Antipneumococcicum — I. Dosage.— First dose, 10,000 units, followed by a second dose of 20,000 in one hour ; the second dose is repeated at intervals of four to six hours until the temperature falls and beneficial effects are evident. The Gilliland Laboratories, Inc., Marietta, Pa. Antipneumococcic Serum Type I. — Marketed in vials containing 50 cc. and 100 cc. ; also in double ended vials containing 50 cc. each, with a gravity injecting apparatus for intravenous injection. Lederle Laboratories, Inc., Pearl River, N. Y. Refined and Concentrated Antipneumococcic Serum, Type I-Lederle. — Prepared by immunizing horses with intravenous injections of cultures of Tyoe I and Type II pneumococci. When test bleedings show the serum 382 NEW AND NONOFFICIAL REMEDIES to have reached a sufficient degree of potency for type I pneumococcus, the horses are bled aseptically and the serum is refined and concentrated by the method of Lloyd D. Felton (/. Infect. Dis., December 1928, p. 543). _ The finished product contains type II pneumococcus antibodies but not in therapeutically important amounts. The usual sterility tests are carried out and safety tests are made by injection into white mice and guinea-pigs. The potency of the product is expressed in terms of the unit described by Felton {Boston M. & S. J., May IS, 1924, p. 819; 7. Infect. Dis., September 1925, p. 199; October 1925, p. 309). While the unit originally was intended to be the amount of antibody that will protect against 1 million fatal doses of culture, it has lately been taken to be one-two hundredth cc. of the control serum (F 146) distributed by Dr. Felton. The product is marketed in packages containing 10,000 and 20,000 units of type I pneumococcus. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Antipneumococcic Serum, Type I. — Prepared by immunizing horses with dead and living pneumococci Type I and standardized by animal potency tests against a highly virulent type I culture. Marketed in packages of one 50 cc. double ended vial. Pneumococcus Antibody Globulin Type I-Mulford. — Prepared by immunizing horses with intravenous injections of cultures of Type I and Type II pneumococci. When test bleedings show the serum to have reached a sufficient degree of potency for type I pneumococcus, the horses are bled aseptically and the serum is refined and concentrated by the method of Lloyd D. Felton (/. Infect. Dis., December, 1928, p. 543). The finished product contains type II pneumococcus antibodies, but not in therapeutically important amounts. The usual sterility and safety tests are made by injection into white mice and guinea-pigs. Standard- ization is effected on the basis both of the mouse protection test and by a specific polysaccharide precipitation test devised by Zozaya, Boyer and Clark (7. Exper. Med., October, 1930, p. 471). The potency of the product is expressed in terms of the unit described by Felton (7. Infect. Dis., September, 1925, p. 199; October, 1925, p. 309; J. A. M. A., June 14, 1930, p. 1893), this unit being the amount of type I pneumococcus antibody that will protect mice against one million fatal doses of the culture. It is marketed in packages containing 10,000 and 20,000 units of type I pneumococcus, accompanied by a vial containing a 1: 10 dilu- tion of pneumococcus antibody globulin type I for the ophthalmic test. The National Drug Co., Philadelphia. Antipneumococcic Serum-Felton-Type I (Refined and Concentrated). — Prepared by immunizing horses with intravenous injections of virulent and avirulent pneumococci and subcutaneous injections of the supernatant broth culture mediums, in which the bacteria had been grown. When test bleedings show the serum has reached a sufficient degree of potency, full bleeding is made. The serum is concentrated by a method similar to that used for antitoxins. Marketed in packages containing 10,000 and 20,000 units of type I pneumococcus antibodies. Parke, Davis & Co., Detroit. Antipneumococcic Serum {Felton) Type I. — Prepared by immunizing horses with killed cultures of highly virulent Diplococcus pneumoniae isolated from lobar pneumonia. The product is refined and concentrated by the method of Dr. L. D. Felton. It is tested by three methods: The precipitation test designed by Dr. Felton, the Felton method of standardi- zation by mouse protection test and the National Institute of Health standard test. The finished product contains type II pneumococcus anti- bodies but not in therapeutically important amounts. It is marketed in packages containing 10,000 and 20,000 units of type I pneumococcus. E. R. Squibb & Sons, New York. Antipneumococcic Serum, Type I. — Marketed in vials containing 50 cc; also marketed in packages of one 50 cc. gravity container. SERUMS AND VACCINES 383 ANTIPNEUMOCOCCIC SERUM, TYPE II. — An antiserum containing predominately antibodies of type II pneu- mococcus (Diplococcus pnemnoniae) . Dosage. — Intravenously, first dose, 10,000 units of each type, followed by a second dose of 20,000 units of each type in one hour; the second dose may be repeated at intervals of from four to six hours until the temperature falls and beneficial effects are evident. Lederle Laboratories, Inc., Pearl River, N. Y. Antipneumococcic Serum, Refined and Concentrated, Type II. — Pre- pared by immunizing horses with intravenous injections of cultures of type I and type II pneumococcus. When test bleedings show the serum to have reached a sufficient degree of potency for type II pneumococcus, the horses are bled aseptically and the serum is refined and concentrated by the method described by Lloyd D. Felton (J. Infect. Dis. 43:543 [Dec] 1928). The usual sterility tests are carried out and safety tests are made by injection into white mice and guinea-pigs. The potency of the product is expressed in terms of the units described by Felton (Bostcnt M. & S. J. 190:819 [May 15] 1924; /. Infect. Dis. 37:199 [Sept.] 1925; 37: 309 [Oct.] 1925) and used by Park. While the unit originally was intended to be the amount of antibody that will protect against one million fatal doses of culture, it has lately been taken to be i/'^op cc. of the control serum (F 146) distributed by Dr. Felton. Marketed in packages of orie syringe containing 10,000 units and in packages of one syringe containing 20,000 units, each accompanied by a vial of normal horse serum (1: 10 dilution) for the conjunctival test. ANTIPNEUMOCOCCUS SERUM TYPES I AND II COMBINED. — An antiserum containing antibodies of both types I and II pneumococci (Diplococci pneumoniae). Dosage. — Intravenously, first dose, 10,000 units of each type, followed by a second dose of 20,000 units of each type, in one hour ; the second dose may be repeated at intervals of from four to six hours until the temperature falls and beneficial effects are evident. Lederle Laboratories, Inc., Pearl River, N. Y. Bivalent Antipneumococcic Serum, Refined and Concentrated. — Pre- pared by immunizing horses with intravenous injections of cultures of type I and type II pneumococci. When test bleedings show the serum to have reached a sufficient degree of potency for types I and II pneu- mococci, the horses are bled aseptically and the serum is refined and concentrated by the method described by Lloyd D. Felton (J. Infect. Dis., December, 1928, p. 543). The usual sterility tests are carried out and safety tests are made by injection into white mice and guinea-pigs. The potency of the product is expressed in terms of the unit described by Felton (Boston M. & S. J., May 15, 1924, p. 819; /. Infect. Dis., Sep- tember, 1925, p. 199; October, 1925, p. 309) and used by Park. While the unit originally was intended to be the amount of antibody that will protect against one million fatal doses of culture, it has lately been taken to be 1^00 cc. of the control serum (F 146) distributed by Dr. Felton. Marketed in packages of one syringe containing 10,000 units each of types I and II, and in packages of one syringe containing 20,000 units each of types I and II, each_ accompanied by a vial of normal horse serum (1: 10 dilution) for the conjunctival test. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Antipneumococcic Serum, Types I and II Combined-Mulford. — A serum obtained from horses immunized with type I and type II pneumococci 384 NEW AND NONOFFICIAL REMEDIES and standardized by animal potency tests. It is marketed in packages of one 50 cc. double end vial and in packages of one vial for intravenous injection, _ Dosage. — From SO to 100 cc. given intravenously and repeated every ' six to eight hours until the temperature falls and beneficial effects are evident. Antipnetimococcic Serum, Concentrated (Pneumococcus Antibody Globu- lin, Types I and II)-Mulford. — A serum obtained by immunizing horses with intravenous injections of type I and type II pneurnococci. It is subjected to the usual sterility and safety tests by injection into white mice and guinea-pigs. Standardization is effected on the basis both of the mouse protection test and by a specific polysaccharide precipitation test devised by Zozaya, Boyer and Clark (/. Exper. Med., October 1930, p. 471). The potency of the product is expressed in terms of the unit described by Felton (7. Infect. Dis., September 1925, p. 199; October 1925, p. 309; The Journal, June 14, 1930, p. 1893). _ Marketed in packages of one 10 cc. syringe containing 10,000 units and in packages of one 20 cc. syringe containing 20,000 units. Dosage. — Initial dose, 10,000 units followed in one hour by a second dose of 20,000 units; the second dose is repeated at intervals of from four to eight hours until the temperature falls and beneficial effects are evident. Parke, Davis & Co., Detroit. Antipneumococcic Serum (Felton) Types I and II Refined and Con- centrated.— Prepared by immunizing horses with injections of killed cultures of Types I and II pneurnococci. The product is refined and con- centrated by the method of Dr. L. D. Felton (J. Infect. Dis., Dec. 1928, p. 543) and contains antibacterial properties against the Types I and II pneumococci. The potency of the product is expressed in terms of the unit described by Felton, one unit being that amount of serum which, when injected simultaneously with a given test dose of culture will pro- tect for 96 hours at least 60 per cent of the test mice. Marketed in packages containing 10,000 Felton units each of Types I and II pneumo- coccus antibodies with a vial of normal horse serum diluted 1; 10 for reac- tion test; and in packages of one vial with syringe attachment containing 20,000 Felton units each of Types I and II pneumococcus antibodies with a vial of normal horse serum diluted 1; 10 for serum reaction test. Dosage. — Intravenously, 20,000 Felton units of each type repeated at intervals of 4 to 6 hours until the temperature falls and beneficial effects are evident. The National Drug Co., Philadelphia. Antipneumococcic Serum Types I and II Refined and Concentrated. — An antipneumococcic serum prepared by immunizing horses with intra- venous injections of avirulent and virulent pneumococcus antibodies of types I and II. The potency of the product is determined and expressed in terms of the unit of Lloyd D. Felton. The serum is concentrated by a method similar to that used for antitoxins. It is marketed in packages of one syringe containing 10,000 units each of pneumococcus antibodies of types I and II; in packages of one syringe containing 20,000 units each of pneumococcus antibodies of types I and II, and in packages of one ampule containing 20,000 units each of pneumococcus antibodies of types I and II. E. R. Squibb & Sons, New York. Concentrated Anti-Pneumococcic Serum, Types I and II. — Prepared by immunizing horses with intravenous injections of cultures of type I and type II pneumococci. When test bleedings show the serum to have reached a sufficient degree of potency for types I and II pneumococci, the horses are bled aseptically and the serum is refined and concentrated by the method described by Lloyd D. Felton (J. Infect. Dis., December, 1928, p. 543). The usual sterility and safety tests are made by injection into white mice and guinea-pigs. The potency of the product is expressed in terms of the unit described by Felton (Boston M. & S. J., May 15, 1924. p. 819; /. Infect. Dis., September, 1925, p. 199; October, 1925, p. 309) and used by Park. While the unilt originally was intended to SERUMS AND VACCINES 385 be the amount of antibody that will protect against one million fatal doses of culture, it has lately been taken to be Y200 cc. of the control serum (F 146) distributed by Dr. Felton. Marketed in packages of one syringe containing 10,000 units each of types I and II; also marketed in packages of one syringe containing 20,000 units each of types I and II pneumococci. ERYSIPELAS ANTISTREPTOCOCCIC SERUM — A serum containing the antibodies and antibacterial properties of hemolytic streptococci from erysipelas. Actions and Uses. — For therapeutic use against erysipelas. It may be of value when administered in adequate doses in the early stages of the disease. Eli Lilly & Co., Indianapolis. Erysipelas Antistreptococcic Serum-Lilly (Concentrated Globulin).-— The serum is obtained from horses immunized with strains of hemolytic streptococci obtained from human cases of erysipelas. It is concentrated by a method similar to that employed in the refineinent of diphtheria antitoxin, the resultant serum containing both neutralizing and bacterial antibodies. Marketed in packages of one syringe containing an average initial therapeutic dose. Dosage. — The contents of one syringe. The National Drug Co., Philadelphia. Erysipelas Antistreptococcus Serum. — The serum is obtained from horses immunized with hemolytic streptococci isolated from patients with erysipelas, also with the toxins produced by these organisms. It is concentrated and refined by a method similar to that used for diphtheria antitoxin. Marketed in packages of one syringe containing 10 cc., the average initial therapeutic dose. A 1 cc. vial of a 1: 10 dilution of serum is included with each package, for scratch or intradermal test, to determine sensitivity of the patient. III. Agents for Producing Active Immunity The use of substances for the production of active immu- nity has at least two advantages over the use of serums : The antibodies formed in the patient's own serum are not lost so rapidly as antibodies from the serum of another species, and, in the second place, not only are the immunity reactions of the blood serum made use of, but the fixed cells of the body may also take part in the immunizing process. Thus, protection from smallpox conferred by vaccination lasts for years, while the prophylactic action of diphtheria antitoxin is of avail only for days. These advantages are frequently offset, however, by the tardiness and uncertainty v/ith which active immunity appears and by the fact that the body may already be overloaded with antigen in the disease or that sufficient antigen to produce an effect would be in itself harmful to the patient. Antigens may be of various sorts. Thus smallpox vaccine, the most notably successful, is conceded to be the living micro- organisms attenuated by passage through the bovine species. Other antigens, such as tuberculins and bacterial vaccines, con- sist of killed whole bacteria or of products formed by them or extracted from them. 386 NEW AND NONOFFICIAL REMEDIES ATTENUATED LIVING VIRUSES RABIES VACCINE. — Antirabic Vaccine. — Antirabic Virus. — Pasteur Treatment. — Pasteur Prophylactic. — "A sterile suspension of the attenuated, diluted, dried or dead, fixed virus of rabies. The virus is contained in the tissue of the central nervous system of an animal suffering from, or dead of, fixed virus rabies infection." U. S. P. For standards see the U. S. Pharmacopeia under Vaccinum Rabies. Actions and Uses. — By treatment with rabies vaccine after the bite of a rabid animal, immunity is usually established before the incubation period of the disease is completed, and rabies is thus prevented. The treatment fails occasionally, and in a small percentage of cases it is followed by paralysis, which is usually transient but may be fatal. Cutter Laboratory, Berkeley, Calif. Rabies Vaccine (Semple). — An antirabic vaccine prepared according to the general method of David Semple (phenol killed). The brains and spinal cords of rabbits killed on the sixth day after inoculation with fixed virus rabies are ground in a mortar with physiological solution of sodium chloride containing 1 per cent of phenol to yield a 10 per cent suspension of brain substance. The mixture is strained, incubated at 37 C. for twenty-four hours and then diluted with an equal volume of physiological solution of sodium chloride so that the finished product contains 5 per cent of brain substance. Marketed in packages of seven syringes, each containing 2.5 cc; also marketed in packages of seven vials each contain- ing 1 cc. The content of a syringe is administered daily over a period of from fourteen to twenty-eight days according to the severity of the case. The Gilliland Laboratories, Inc., Marietta, Pa. Pasteur Anti-Rabic Vaccine. — The virus is prepared in accordance with the general method of the U. S. Public Health Service. One- fifth of an inch of dried cord, emulsified in 0.6 cc. of 60 per cent glycerin containing 0.3 per cent trikresol is supplied. This is diluted with 2.5 cc. of sterile physiological solution of sodium chloride in syringes; the dilution is made at the time of injection. The treatrijent consists of twenty-one doses which are administered at twenty-four hour intervals, and these are sent in three instalments of seven doses each. The instalments are sent by special delivery mail. The first dose con- sists of two sections of a cord dried for six days; the second dose con- sists of two sections of a cord dried for five days; and the third dose two sections of a cord dried for four days. The remaining eighteen doses are prepared from single sections of cords dried as follows: 3, 3, 2, 2, 1, 5, 4, 4, 3, 3, 2, 2, 4, 3, 2, 3, 2, 1 days. They are administered in the order listed. Rabies Vaccine-Gilliland (Semple Method). — An antirabic vaccine pre- pared according to the general method of David Semple (phenol killed). The brain and cord of rabbits killed after inoculation with fixed rabies virus are emulsified in a ball mill, after which a sufficient quantity of physiologic solution of sodium chloride containing 1 per cent of phenol is added to yield an 8 per cent emulsion of the fixed virus. The emulsion is incubated at 37.5 C. for twenty-four hours and then diluted with an equal volume of physiologic solution of sodium chloride so that the finished product contains 4 per cent of the brain and cord substance in 0.5 per cent phenol. Marketed in packages of fourteen syringes each containing 2 cc; also in packages of fourteen vials, each containing 2 cc. The content of a syringe or vial is administered daily over a period of fourteen days. SERUMS AND VACCINES 387 Dr. D. L. Harris' Laboratory, St. Louis (National Patho- logical Laboratories, St. Louis, Mo.). Rabies Vaccine (Harris). — Brains and spinal cords of rabbits that have been killed after fixed virus rabies infection, are ground to a paste, which is frozen in a container surrounded w^ith carbon dioxide snow. The mass is pulverized and rapidly dried in vacuo. The resulting dry powder is standardized by the method devised by Dr. Harris, and stored in vacuo in the cold. One dose is given daily over a period of ten days or more, the early doses increasing in unitage up to a maximum. Each package contains vaccine and apparatus for the administration of one complete treatment, consisting of 10 tubes of rs.bies vaccine (Harris), sealed in a vacuum, and numbered consecutively; 10 vials containing physiological solution of sodium chloride for preparing the vaccine solution; and a Luer syringe with needle. Hixson Laboratories, Inc., Johnstown, Ohio. Rabies Vaccine (Hixson). — An antirabic vaccine prepared according to the general method of David Semple (phenol killed). The brains of rabbits killed after inoculation with fixed rabies virus are emulsified in a 1 per cent phenol solution by shaking with steel beads. The emulsion is passed through a 100 mesh sieve, diluted to yield an 8 per cent emulsion, incubated at 37.5 C. for twenty-four hours, and then diluted with an equal volume of physiologic solution of sodium chloride so that the finished product contains 4 per cent of brain substance, 0.5 per cent of phenol, and 0.85 per cent of sodium chloride. Marketed in packages of seven vials each containing 2 cc; in packages of fourteen vials each containing 2 cc. ; and in packages of fourteen syringes each containing 2 cc. In most cases the content of a syringe or vial (one dose) is administered daily over a period of fourteen days. For bites about the head or neck two doses are given daily for seven days followed by one dose daily for from seven to fourteen days, according to the severity of the bite. Jensen-Salsbery Laboratories, Inc., Kansas City, Mo. Rabies Vaccine (Human), Phenol Killed. — The virus is prepared according to the general method of David Semple. The brain and cord, removed from a rabbit paralyzed on the sixth, seventh, or eighth day following a subdural inoculation of fixed virus rabies, are tested for sterility before emulsifying, then reduced to a fine suspension by shaking in a sterile bottle containing beads. The virus is killed by suspending the brain and cord substance in a sterile 1 per cent phenol saline solution in proportion of 4 per cent brain substance. This resulting suspension is kept at 37 C. for 24 hours; finally it is diluted with an equal volume of sterile physiological solution of sodium chloride, so that the product as sold contains brain substance, 2 per cent and phenol, 0.5 per cent. Marketed in packages containing 14 vials and a syringe, and in packages containing 21 vials and a syringe. The content of vial 1 and of vial 2 is administered on the first day of treatment allowing 4 to 6 hour intervals; the other doses are administered in sequence at 24 hour intervals until the treatment is completed. Lederle Laboratories, Inc., Pearl River, N. Y. Rabies Vaccine-Lederle (Semple Method). — An antirabic vaccine pre- pared according to the general method of David Semple (phenol killed). The brains of rabbits killed on the sixth or seventh day after inoculation with fixed virus rabies are ground in a ball mill for four days with physiological solution of sodium chloride containing 1 per cent phenol to yield an 8 per cent suspension of brain substance. The mixture is incubated at 37 C. for twenty-four hours and then diluted with an equal volume of physiological solution of sodium chloride so that the finished preparation contains 4 per cent of brain substance and 0.5 per cent of phenol. Marketed in packages of fourteen vials each containing 2 cc. with one Luer syringe. EH Lilly & Co., Indianapolis. Rabies Vaccine (Harris) -Lilly — Sterile brains and spinal cords of rabbits killed after complete paralysis from rabies fixed virus infection are pul- verized during refrigeration with carbon dioxide snow and then rapidly 388 NEW AND NONOFFICIAL REMEDIES dried in vacuo over sulfuric acid. The resulting dry powder is stand- ardized by the method devised by Dr. Harris, and stored in vacuo in the cold. One dose (0.5 cc.) is given daily over a period of fourteen days. Marketed as a suspension of powdered virus in sterile water in vials for use with a special syringe unit. Medical Arts Laboratory, Inc., Oklahoma City, Okla. Rabies Vaccine (Killed Virus). — An antirabic vaccine prepared accord- ing to the general method of David Semple (phenol killed). It consists of a sterile suspension, in distilled water, of the brain and cord substance of rabbits moribund from the injection of fixed virus rabies. The virus is killed by the use of phenol and by incubation at 37 C. for forty-eight hours. The finished product contains 0.5 per cent of phenol. Marketed in packages of 14 vials, each containing 2 cc. and in packages of 14 individual syringes, each containing 2 cc. All of the doses are of the same potency: 1 dose is to be given daily over a period of fourteen days. _ In severe face bites or when treatment has been delayed, 2 doses are given daily for four or five days with at least a total of twenty-one doses. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Rabies Vaccine (Phenol Killcd)-Mulford. — The virus is prepared according to the general rnethod of David Semple. It consists of a sterile suspension of the brain tissue of rabbits moribund from the injec- tion of virulent fixed rabies virus. The virus is killed by the use of phenol and by incubation at 37.5 C. for three days. Marketed in pack- ages of 7 doses, each dose consisting of ^ cc. of a 25 per cent suspension of brain tissue contained in one syringe or vial, two 7 dose packages being sufficient for the 14 dose treatment and three for the 21 dose treatment; also in packages of 7 vials, each vial (one dose) containing 0.5 cc. of a 25 per cent suspension of brain tissue. All of the doses are of the same potency and in the treatment of the average case, 14 doses are recom- mended and administered at daily intervals. In the treatment of severe cases, two doses are injected daily for the first 7 days, supplemented with one additional dose for the next 7 days. The National Drug Co., Philadelphia. Rabies Vaccine (Hummi), (Chloroform Killed) — A^. D. Co. — Antirabic vaccine prepared according to a modification of the method of David Semple (chloroform killed). The brains and spinal cords of rabbits killed on the sixth or seventh day after inoculation with fixed rabies virus are ground with physiologic solution of sodium chloride containing 2 per cent chloroform, to yield a 25 per cent suspension of brain and cord substance. The suspension is then placed in the refrigerator at 2 to 5 _C._ for two months. It is then tested for absence of living virus by rabbit injection. The finished product represents a 25 per cent emulsion. Marketed in packages of fourteen vials, each containing a dose of 0.5 cc, and in packages of fourteen syringes, each containing a dose of 0.5 cc. Parke, Davis & Co., Detroit. Rabies Vaccine (Cumming). — The virus is prepared by dialyzing a 1 per cent suspension of brain tissues (from a rabbit dying of rabies induced by an infection of fixed virus) against running water until the active virulent virus is destroyed. The treatment is divided into two classes: mild, requiring 14 doses; severe, requiring 21 doses. One dose, 2 cc, is given daily over a period of either 14 or 21 days. Marketed in packages of 7 syringe containers of 2 cc. each (1 dose) and in packages of seven 2 cc. vials each containing one dose. E. R. Squibb and Sons, New York. Rabies Vaccine (Killed Virus) Squibb (Semple Method). — An antirabic vaccine prepared according to the general method of David Semple (phenol killed). The brains of rabbits killed on the sixth day after inocu- lation with fixed virus rabies, are ground in a ball mill with physiological solution of sodium chloride containing 1 per cent of phenol to yield a 10 per cent suspenson of brain substance. The mixture is incubated at 37 C, SERUMS AND VACCINES 389 for twenty-four hours and then diluted with an equal volume of physio- logical solution of sodium chloride so that the finished product contains 5 per cent of brain substance. Marketed in packages of fourteen vials, each containing 2 cc. The content of a vial is administered daily over a period of fourteen days. Terrell's Laboratories, Fort Worth, Texas. Rabies Vaccine f Phenolized). — An antirabic vaccine prepared according to the general method of David Semple (phenol killed). The brain and cord of rabbits killed after inoculation with fixed virus rabies are ground in a mortar with distilled water containing 2 per cent of phenol to yield a 6 per cent emulsion of the fixed virus. The emulsion is incubated at 37 C. for forty-eight hours and then diluted with distilled water so that the finished product contains 1.5 per cent of the brain and cord substance and 0.5 per cent phenol. Marketed in packages of fourteen vials each containing 3 cc, and in packages of twenty-one vials each_ containing 3 cc. The content of a vial is administered daily over a period of from fourteen to twenty-one days according to the severity of the case. Ordi- narily one dose is given daily but under certain conditions, such as badly lacerated wounds, bites in children, bites about the face and bites that have occurred some time before treatment is begun, two doses may be given daily for the first few days, then one dose daily until treatment is finished. United States Standard Products Company, Woodworth, Wis. Rabies Vaccine (Killed Virus) Semple (U. S. S. P. Co.). — An antirabic vaccine prepared according to the general method of David Semple (phenol killed). The brains of rabbits killed after inoculation with fixed virus of rabies are placed in a bottle containing beads and 1 per cent phenol solution. The bottle is thoroughly shaken, the resultant emulsion passed through 100 mesh screen, and sufficient 1 per cent phenol solution added to yield a 20 per cent emulsion, used in preparation of 1 cc. dose vaccine, or an 8 per cent emulsion, used in preparation of 2 cc. dose vaccine. The emulsions are incubated at 37 C. for 24 hours, then diluted with an equal volume of physiologic solution of sodium chloride. The final product is a 10 per cent emulsion of brain substance or a 4 per cent emulsion of brain substance in 0.5 per cent phenol. Marketed in packages of 14 vials each containing 1 cc. of a 10 per cent emulsion (or a total of 25 per cent more brain substance than the 2 cc. 4 per cent emulsion contains) ; also in 4 per cent emulsion in the following packages, each vial or syringe containing a 2 cc. dose: 7 dose vial package, 7 dose syringe package, 14 dose vial package, 14 dose syringe package, and 21 dose syringe package; also supplied in the form of a 25 per cent suspen- sion of brain substance containing O.S per cent of phenol. Marketed in packages of seven and fourteen vials each containing a single dose (0.5 cc). The content of a syringe or vial is administered daily over a period of 14 days. In cases of exceptional severity additional dosage may he administered at the discretion of the physician. TOXIN-ANTITOXIN MIXTURE DIPHTHERIA TOXIN-ANTITOXIN MIXTURE. — Mistura Toxini Diphtheric! et Antitoxini Diphtherici. — A mixture of diphtheria toxin and diphtheria antitoxin. Labelled to show the volume of each dose and the number of L + doses of toxin contained in each dose. The product should be used only if clear and free from sedi- ment or flocculi. The antitoxin used in diphtheria toxin-antitoxin mixture is produced from the horse, goat or sheep. Diphtheria toxin- antitoxin mixture has been almost entirely supplanted by diph- theria toxoid. Actions, Uses and Dosage. — Diphtheria toxin-antitoxin mix- ture is used for active immunization against diphtheria. It is 390 NEW AND NONOFFICIAL REMEDIES administered subcutaneously, preferably at the insertion of the deltoid, in three doses with an interval of one week between doses. A Schick test performed about six months after the last injection determines whether further immunization is necessary. In the presence of an outbreak of diphtheria an immunizing dose of diphtheria antitoxin alone should be used if patients are remote from regular medical observation. The Gilliland Laboratories, Inc., Marietta, Pa. Diphtheria Toxin-Antitoxin^ Mixture, 0.1 L + . — Each cubic centimeter represents 0.1 L+ dose of diphtheria toxin neutralized with the required amount of diphtheria antitoxin. Marketed in packages of 3 ampules, each ampule containing 1 cc; in packages of 30 ampules, each arnpule containing 1 cc. ; in packages of 3 syringes, each syringe containing 1 cc; and in ampules containing, respectively, 10 cc, 20 cc. and 30 cc. Hixson Laboratories, Inc., Johnstown, Ohio. Diphtheria Toxin-Antitoxin Mixture, 0.1 L + . — Each cubic centimeter represents 0.1 L+ dose of diphtheria toxin neutralized with the proper amount of diphtheria antitoxin obtained from the horse; preserved with merthiolate 1:10,000. Marketed in packages of three 1 cc. vials, in packages of one 10 cc. vial, and in packages of one 30 cc. vial. Diphtheria Toxin-Antitoxin Mixture, 0.1 L-j- (Sheep). — Each cubic centimeter represents 0.1 L+ dose of diphtheria toxin neutralized with the proper amount of diphtheria antitoxin obtained from sheep; preserved with merthiolate 1:10,000. Marketed in packages of three 1 cc. vials, in packages of one 10 cc. vial, and in packages of one 30 cc. vial. Lederle Laboratories, Inc., Pearl River, N. Y. Diphtheria Toxin-Antitoxin Mixture (0.1 L-\-). — A mixture containing 0.1 L-j- dose of diphtheria toxin neutralized with that amount of antitoxin necessary to bring the mixture to the correct toxicity. Marketed in packages of three vials, representing one complete immunization; and in packages of one 30 cc. vial, representing ten immunizations. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Diphtheria Toxin-Antitoxin Mixture, New Formula (Park-Banzhaf's 0.1 L-\-). — Each cubic centimeter of the mixture constitutes a single dose containing 0.1 lethal dose (1/10 L+) of toxin properly neutralized with the necessary amount of diphtheria antitoxin marketed in packages of three 1 cc. vials representing one immunizing treatment; also in pack- ages of one 30 cc. vial representing ten immunizing treatments of three doses each; also marketed in packages of one 10 cc. vial representing three immunizing treatments. The National Drug Co., Philadelphia. Diphtheria Toxin-Antitoxin Mixture (Diphtheria Prophylactic). — Each cubic centimeter represents 0.1 L-f dose of diphtheria toxin neutralized with the required amount of antitoxin produced from goats, marketed in packages of three 1 cc. vials, one immunization; in packages of one 15 cc. vial, five immunizations; in packages of one 30 cc. vial, ten immuniza- tions; and in packages of thirty 1 cc. vials, ten immunizations. Parke, Davis & Co., Detroit. Diphtheria Toxin- Antitoxin Mixture, Diphtheria Prophylactic (Goat). — Each cubic centimeter of the mixture represents 0.1 L-|- dose of diphtheria toxin neutralized with the required amount of antitoxin produced from goats. Marketed in packages of 3 bulbs, each containing 1 cc. repre- senting one immunizing treatment; also in rubber-capped vials containing 30 cc; also marketed in packages of 10 vials each containing 3 cc, representing ten immunizing treatments. SERUMS AND VACCINES 391 E. R. Squibb and Sons, New York. Diphtheria Toxin-Antitoxin Mixture (New Formula) (Sheep)-Squibb. — Each cubic centimeter represents 0.1 L+ dose of diphtheria toxin neutral- ized with the required amount of antitoxin obtained from the sheep. Marketed in packages of three ampules, each ampule containing 1 cc. of the mixture, and in vials containing, respectively, 10 and 30 cc. United States Standard Products Company, Woodworth, Wis. Diphtheria Toxin-Antitoxin Mixture 0.1 L+ Non-Sensitizing (Sheep). — Each cubic centimeter constitutes a single dose of diphtheria toxin neutral- ized with the proper amount of antitoxin produced from sheep. Marketed in packages of three vials, each containing 1 cc; in packages of one vial containing 10 cc; in packages of one vial containing 30 cc, and in packages of thirty vials, each containing 1 cc. TUBERCULINS Many different methods have been used to prepare from the tubercle bacillus substances which might be used in the diag- nosis, treatment or prophylaxis of tuberculosis. These have been, in general, called tuberculins, and a few of the more prominent are enumerated here. For diagnosis, Koch's old tuberculin is almost exclusively employed. For treatment, each tuberculin has its advocates, but it is doubtful whether there is any essential difference in the action of the various forms. The strength varies, however, not only in tuberculins prepared by different methods, but also in different batches prepared in exactly the same manner. When a correct dosage for an individual has been found, therefore, a change to a different laboratory number of the same preparation should be accom- panied by a reduction to one half the dose in order to avoid a severe reaction. The plan of treatment provides usually for a gradual increase in dose, keeping the doses low enough to prevent any marked constitutional disturbance. For this reason, the active cooperation of the patient is necessary, and an accurate record must be kept of the temperature and pulse at frequent intervals during the day and of the slightest change in subjective or objective symptoms. The immunity to tuberculin acquired by this increasing dosage is not an immunity to tuber- culosis ; but the advocates of this tuberculin treatment claim that it frequently is accompanied by clinical improvement. The usual hygienic-dietetic measures should be carried out as well. Danger from Tuberculins. — The early history of the use of tuberculin is full of instances showing that it is a dangerous substance. The great risk lies in the chance of a severe reac- tion, and every precaution should be taken, both in diagnosis and in treatment, not to underestimate the patient's susceptibility to the tuberculin. This susceptibility varies enormously in different individuals and at different stages of the treatment, entirely out of relation to the progress of the disease. The use of tuberculin, therefore, requires special knowledge and expe- rience. 392 NEW AND NONOFFICIAL REMEDIES OLD TUBERCULIN. — Tuberculin-Koch.— Concentrated Tuberculin. — Crude Tuberculin. — "A sterile solution in a spe- cial liquid culture medium of the soluble products of growth of the tubercle bacillus (Mycohacterhim tuberculosis) and should contain about 50 per cent of glycerin." U. S. P. For standards see the U. S. Pharmacopeia under Tubercu- linum Pristinum. Actions and Uses. — For diagnosis, old tuberculin may be used by hypodermic injection to show a reaction at the site of application (local), at the site of suspected disease (focal), or general (constitutional). If positive, the tuberculin reaction merely indicates that the patient has at some time been infected with tuberculosis and not necessarily that he has clinical tuber- culosis. In many advanced or acute cases of tuberculosis, the patients do not react, so that the result of a tuberculin test is never absolute but always must be judged in the light of other findings. The occurrence of a focal reaction is good presump- tive evidence of an active lesion. For children, the intracutaneous (Mantoux) test is generally employed. Concentrated old tuberculin is diluted, under sterile precautions, so that 0.1 cc. (the quantity to be injected) will contain 0.01 mg. of old tuberculin. Dilution of the tuberculin should be made on the day of test. The diluted material should be injected intracutaneously into the skin of the flexor surface of the forearm. A 1 cc. tuber- culin syringe and a sharp 26 gauge one-half inch needle are used. The reactions are read 48 to 72 hours after injection. No reading should be made after 72 hours. If the reaction is negative following a dose of 0.01 mg., a second dose of 0.1 mg. should be injected into the opposite forearm. If after 48 hours no reaction follows the 0.1 mg. dose, the patient should be given a dose of 1.0 mg. In the absence of a reaction following this last dose of tuberculin, the patient is regarded as negative. The reaction consists in a zone of redness, usually with a papule, at the point of the tuberculin injection. This reaction reaches its height in forty-eight hours. After infancy an increasing proportion of those who react are found to be free from clinical tuberculosis. The subcutaneous test is used more frequently on adults. A two-hour temperature chart should be kept for two days preceding and two days following each injection. To an adult in good condition, 0.0002 cc. may be given as the initial dose, and if there is no reaction 0.001 cc. and then 0.005 cc. may be tried. The doses should be given at least three days apart; and if there is the slightest sugges- tion of a reaction in temperature or symptoms, the dose should be repeated, not increased. Children and weak patients should receive smaller doses, but no very weak patient or one with a fever should be subjected to the danger of a subcutaneous test. A rise of temperature of 1 degree Fahrenheit may be SERUMS AND VACCINES 393 taken as a reaction, especially if accompanied by changes at the site of the disease. This reaction means, just as with the cutaneous test, only infection and not necessarily clinical tuber- culosis ; and owing to the danger of large doses, patients may fail to react because, though sensitive to tuberculin, they are not sensitive to doses small enough to be used safely. For treatment, from one one hundred-millionth (0.00000001) to one millionth (0.000001) cc. may be used as the initial dose, and not more than two doses a week should be given. Cutter Laboratories, Berkeley, Calif. Tuberculin for the Cutaneous Reaction (Pirquet's Reaction). — Marketed in packages containing three capillary tubes. Tuberculin Old (Tuberculin O. T.). — Prepared from strains of the human type. Marketed in 1 cc. vials of concentrated tuberculin; also in serial dilutions, ranging from 0.001 to 100 mg. per cubic centimeter. The Gilliland Laboratories, Inc., Marietta, Pa. Lntracutaneous Tuberculin for the Mantoux Test. — Marketed in pack- ages of one 1 cc. vial containing diluted tuberculin sufficient for ten tests. Each dose of 0.1 cc. represents 0.0001 Gm. of tuberculin. Original Tuberculin, "O. T." — Marketed in 1 cc. and 3 cc. vials. Tuberculin "O. T." (Old Tuberculin). — Marketed in packages contain- ing a stated amount of tuberculin with 10 cc. of diluent, so that 1 cc. represents: no. 1 Dilution (each cubic centimeter equals 0.01 mg.) ; no. 2 dilution (each cubic centimeter equals 0.1 mg.); no. 3 dilution (each cubic centimeter equals 10 mgj ; nu. 5 dilution (each cubic centi- meter equals 100 mg.). Supplied only on orders direct from laboratories. Tuberculin Ointment in Capsules (for the Moro Percutaneous Diag- nostic Test). — An ointment consisting of tuberculin "old" and anhy- drous wool fat equal parts. Marketed in capsules sufficient for one test. Tuberculin Solution for the Von Pirquet Cutaneous Diagnostic Test. — Old tuberculin in capillary tubes, each sufficient for one test. ]\Iarketed in packages of one, live and ten tubes; also in vials of 1 cc. and 3 cc. Lederle Laboratories, Inc., Pearl River, N. Y. Intracutaneous Tuberculin for the Mantoux Test. — -Marketed in pack- ages of one vial containing tuberculin "O. T." accompanied by a vial containing physiological solution of sodium chloride sufficient to make 1 cc; when mixed, the content of the two vials represents 0.001 Gm. of tuberculin. Tuberculin Pirquet Test ("O. T."). — Old tuberculin marketed in packages containing three glass capillary tubes and three scarifiers; and in packages containing ten capillary tubes. Tuberculin "Old" (Koch's Old Tuberculin). — Marketed in packages con- taining a stated amount of tuberculin with sufficient diluent to make 1 cc, as follows: Dilution A, containing 0.1 cc; Dilution B. contain- ing 0.01 cc. ; Dilution C, containing 0.001 cc ; Dilution D, containing 0.0001 cc; Dilution E, containing 0.00001 cc, and Dilution F, contain- ing 0.000001 cc. Also marketed in packages containing 1 cc. of tuberculin. Eli Lilly & Co., Indianapolis. Pirquet Test.- — Old tuberculin marketed in packages of three capillary tubes, each tube containing sufficient tuberculin for one test. Tuberculin Ointment for the Moro Percutaneous Test. — Marketed in collapsible tubes, containing 2 Gm. of an ointment consisting of equal parts of old tuberculin and anhydrous wool fat. Old Tuberculin, Human Strain Concentrated. — Marketed in 1 cc. vials (1 Gm. tuberculin) for making doses for therapeutic use or for making the subcutaneous tuberculin test; also in 1 cc. vials containing a stated amount of concentrated tuberculin for making dilutions, containing from 394 NEW AND NONOFFICIAL REMEDIES 0.001 to 100 mg. tuberculin per cubic centimeter. A vial of physiologic solution of sodium chloride is included in each package for makng serial dilutions. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Tuberculin "Old" (O. T.). — Marketed in packages of 1 cc. vials; also in serial dilutions in five vials of 8 cc. each, the first containing 0.001 mg. in each 2 minims, and each succeeding dilution being ten times stronger than the preceding. Dosage. — Two minims. Pirquet Test for Tuberculosis. — Old tuberculin marketed in capillary tubes, put up in packages of, respectively, one, three and ten tubes, each tube containing old tuberculin sufficient for one test, together with packages containing an equal number of tubes of concentrated glycerin bouillon for use as a control. The National Drug Co., Philadelphia. Tuberculin Intracutaneous for Mantoux Test. — Marketed in packages of one intradermal syringe (single test), containing 0.1 cc. of a 1 in 1,000 dilution of old tuberculin (O. T.), with a vial of glycerin bouillon for control; in packages of two intradermal syringes (double test), one con- taining 0.1 cc. of a 1 in 1,000 dilution of old tuberculin (O. T.) with vial of glycerin bouillon for control and the other containing 0.1 cc. of a 1 in 100 dilution of old tuberculin (O. T.) with vial of glycerin bouillon for control; in packages of one 1 cc. ampule containing sufficient intradermal tuberculin solution for ten single tests; in packages of two 1 cc. ampules containing sufficient intradermal tuberculin solution for ten double tests; and in packages of one 5 cc. ampule containing sufficient intradermal tuberculin solution for fifty single tests. Tuberculin Old (Human). — Marketed in single 1 cc. vial packages, each cubic centimeter representing 1 Gm. tuberculin-Koch. Also sup- plied on special order, in 10 cc. ampule vials of five serial dilutions; dilutions 1 to 4 representing in each two minims, respectively, 0.001 mg., 0.01 mg., 0.1 mg., and 1 mg. of old tuberculin, and dilution 5 rep- resenting 10 mg. of old tuberculin in each minim. Von Pirquet Test for Tuberculosis. — Old tuberculin marketed in pack- ages of one, three and ten capillary tubes; capillary tubes containing glycerin bouillon for control are included in each package. Parke, Davis & Co., Detroit. Tuberculin "Old"' (Koch). — Marketed in 1 cc. bulbs. Tuberculin (Old) and Control for the Pirquet Test. — Marketed in pack- ages containing three sealed glass tubes of tuberculin, each tube con- taining tuberculin sufficient for one test, and three tubes of control material. Tuberculin for the Mantoux Test. — A filtrate from bouillon cultures of both human and bovine strains of Bacterium tuberculosis (Mycobac- terium tuberculosis) representing a ten-fold concentration and containing 50 per cent of glycerin as a preservative. Marketed in packages of two 10 cc. vials, one containing 0.01 cc. tuberculin old (Koch), and the other 10 cc. of diluent. NEW TUBERCULIN, B. E.— Tuberculinum Novum B. E. — Bazillenemulsion, Koch. — Bacilli Emulsion. — Bacilli emulsion is practically a bacterial vaccine. It is made by sus- pending one part of pulverized tubercle bacilli, B. tubercnlosis (Mycobacterium tubercnlosis), in 100 parts of distilled water and 100 parts of glycerine. One cc. thus corresponds to 5 mg. of tubercle bacilli. SERUMS AND VACCINES 395 It is a white, fairly permanent esmulsion, but should be shaken thoroughly before making dilutions. New tuberculin, B. E., is used in the therapeutics of tuberculosis probably more frequently than any other tubercle preparation. Lederle Laboratories, Inc., Pearl River, N. Y. Tuberculin "B. E." (Bacillus Emulsion). — Marketed in vials contain- ing 1 cc; also in packages containing a stated amount of tuberculin with sufficient diluent to make 1 cc, as follows: Dilution A, containing 0.1 cc; Dilution B, containing 0.01 cc; Dilution C, containing 0.001 cc. ; Dilution D, containing 0.0001 cc; Dilution E, containing 0.00001 cc. ; and Dilution F, containing 0.000001 cc. Alulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Bacillen Emulsion "B. E." — Marketed in packages of 1 cc. vials; also in serial (six) dilutions. Parke, Davis & Company, Detroit. Tuberculin B. E. (Concentrated). — Bacillus emulsion, marketed in bulbs containing 1 mg. of dry tubercle solids per cubic centimeter. NEW TUBERCULIN B. E. DRIED— Tuberculinum Novum B. E. Siccum. — A solution of this is practically a bacterial vaccine. The bacteria, B. tuberculosis (Mycobacterium tuberculosis), are dried, ground, mixed with a suitable base, and made into tablets. The diluent is adjusted so that one tablet dissolved therein will represent the desired amount of new tuberculin B. E. dried, per cc. Parke, Davis & Company, Detroit. Tablets Tuberculin B. E.-P. D. & Co.— Marketed in vials no. 1 of ten tables, each tablet containing 0.0001 mg. new tuberculin B. E. dried; in vials no. 2 of ten tablets, each tablet containing 0.001 mg. new tuber- culin B. E. dried; in vials no. 3 of ten tablets, each tablet containing 0.01 mg. new tuberculin B. E. dried; in vials no. 4 of ten tablets, each tablet containing 0.1 mg. new tuberculin B. E. dried; in vials no. 5 of ten tablets, each tablet containing 1 mg. new tuberculin B. E. dried; also marketed in packages of 5 vials, nos. 1, 2, 3, 4 and 5. NEW TUBERCULIN-T. R. — Tuberculinum Novum T. R. — Tuberkelbacillin Rest, Koch. — Tuberculin Residue. — Tuberculin Riickstand. — This is made from living dried tubercle bacilli, B. tuberculosis (Mycobacterium tuberculosis), hy gv'mdmg to complete disintegration. The water insoluble material is sus- pended in glycerine and water. The final product contains the residue of 10 mg. of dried tubercle bacilli in each cc. of fluid. New tuberculin is an uncolored, slightly opalescent liquid. It is used occasionally in the treatment of tuberculosis. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Tuberculin T. R. — Marketed in serial dilutions of six graduated strengths. Parke, Davis & Co., Detroit. Tuberculin T. R. (Concentrated). — Marketed in single 1 cc. bulbs con- taining 1 mg. of tubercle solids per cubic centimeter. 396 NEW AND NONOFFICIAL REMEDIES NEW TUBERCULIN T. R. DRIED.— Tuberculinum Novum T. R. Siccum. — Tuberculin Residue (Dried). — The mass culture of B. tuberculosis (Mycobacterium tuberculosis) is repeatedly ground and washed until all water soluble material has been removed. The residue is then ground to complete disintegration, dried, mixed with a suitable base and made into tablets. Each tablet represents a definite amount of dry tubercle bacilli. Parke, Davis & Company, Detroit. Tablets Tuberculin T. R.-P. D. & Co.— Marketed in vials no. 1 cf ten tablets, each tablet containing 0.0001 mg. new tuberculin T. B. dried; in vials no. 2 of ten tablets, each tablet containing 0.001 mg. new tuberculin T. R. dried; in vials no. 3 of ten tablets, each tablet con- taining 0.01 mg. new tuberculin T. R. dried; in vials no. 4 of ten tablets, each tablet containing 0.1 mg. new tuberculin T, R. dried; in vials no. 5 of ten tablets, each tablet containing 1 mg. new tuberculin T. R. dried; also marketed in packages of 5 vials, nos. 1, 2, 3, 4 and 5, inclusive. TUBERCULIN DENYS. — Tuberculinum Denys.— Tuberculine Bouillon Filtre. — Bouillon Filtrate Tuberculin, — This is prepared like old tuberculin, without the prolonged heating and concentration ; that is, it is simply a glycerin-broth culture of the tubercle bacillus, B. tuberculosis (M. tubercu- losis), passed through a porcelain filter. It contains all the soluble products of the growth of the tubercle bacillus. Parke, Davis & Co., Detroit. Tuberculin B. F. (Boznne). — A tuberculin Denys prepared with bovine cultures of Bacterium tuberculosis, containing 0.4 per cent of cresol. Marketed in packages of six 1 cc. rubber-stoppered glass tubes. Tuberculin B. F. (Human). — A tuberculin Denys prepared with human cultures of Bacterium tuberculosis, containing 0.4 per cent of cresol. Marketed in packages of six 1 cc. rubber-stoppered bulbs. BACTERIAL TOXIN SCARLET FEVER STREPTOCOCCIC TOXIN.— Scarlet Fever Toxin for Immunization and the Dick Test. — "A sterile solution in beef broth of certain products including a soluble toxin, resulting from the growth in the broth of suitable strains of the hemolytic streptococci (Streptococcus scarlatinae)." U. S. P. For standards see the U. S. Pharmacopeia under Toxinum Scarlatinae Streptococcicum. Actions, Uses and Dosage. — The toxin is used for active immunization. For this purpose it is injected subcutaneously at weekly intervals. The amount of toxin necessary for immunity production varies with the individual. From three to five doses are given, beginning with 250 to 500 skin test doses for the first injection and increasing the amount of toxin in each subsequent injection. Immunity to the toxin appears in a few weeks and is determined by the absence of a reaction to the intracutaneous test. SERUMS AND VACCINES 397 Lederle Laboratories, Inc., Pearl River, N. Y. Scarht Fever Streptococcus Immunising To.vm.— ^Prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. Marketed in single immunization packages of five vials of toxin containing, respec- tively, 500, 2,000, 8,000, 25,000 and 80,000 skin test doses; also marketed in ten immunization packages of six 10 cc. vials of toxin containing, respectively, 500, 2,000, 8,000, 25,000, 80,000 and 80,000 skin test doses per cubic centimeter; also marketed in packages of one 2 cc. vial contain- ing 80,000 to 100,000 skin test doses of scarlet fever streptococcus toxin for supplementary treatment of those patients who fail to become Dick negative after receiving the full live dose series of scarlet fever strepto- coccus immunizing toxin. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Scarlet Fever Streptococcus Toxin for Immunization-Mulford: Pre- pared by the method of Drs. Dick under U. S. Patent 1,547,369 (July 29, 1925; expires 1942) by license of the Scarlet Fever Committee Incorporated. Marketed in packages of five ampoule-vials containing, respectively, 500, 2,000, 8,000, 25,000 and from 80,000 to 100,000 skin test doses; also in packages containing ten complete treatments consisting of six 10-cc. vials, one containing 500 skin test doses per cubic centi- meter, one containing 2,000 skin test doses per cubic centimeter, one containing 8,000 skin test doses per cubic centimeter, one containing 25,000 skin test doses per cubic centimeter and two containing from 80,000 to 100,000 skin test doses per 2 cubic centimeters. The National Drug Co., Philadelphia. Scarlet Fever Streptococcus Toxin for Immunization-" National." — Prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. Marketed in packages of five vials, containing, respectively, 500, 2,000, 8,000, 25,000 and 80,000 skin test doses. Also marketed in single vial packages containing 100.000 skin test doses; and in packages of six 10 cc, vials of toxin, one containing 500 skin test doses, one con- taining 2,000 skin test doses, one containing 8,000 skin test doses, one containing 25,000 skin test doses, and two containing 80,000 skin test doses. Parke, Davis & Co., Detroit. Scarlet Fever Streptococcus Toxin for Preventive Immunization- P. D. & Co. — Prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. Marketed in packages of five vials of toxin containing, respectively, 500, 2,000, 8,000, 25,000 and 80,000 skin test doses; also marketed in packages of six 1 cc. vials, one containing 500 skin test doses per cc, one containing 2,000 skin test doses per cc, one containing 8,000 skin test doses per cc, one containing 25,000 skin test doses per cc, and two containing 40,000 skin test doses per cc, of which 2 cc. is used for the fifth dose. E. R. Squibb & Sons, New York. Scarlet Fever Streptococcus Toxin for Immunizatioyi-Squibb. — Prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. Marketed in packages of five vials of toxin containing, respectively, 500, 2,000, 8.000, 25,000 and 80,000 skin test d&ses; also marketed in packages of six 10 cc. vials of toxin containing, respectively, 500, 2.000, 8,000, 25,000, 40,000 and 40,000 skin test doses per cubic centimeter. United States Standard Products Company, Woodworth, Wis. Scarlet Fever Streptococcus Toxin for Immunization. — Prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee Inc. Marketed in single immunization packages of five vials containing, respectively. 398 NEW AND NONOFFICIAL REMEDIES 500, 2,000, 8,000, 25,000 and 80,000 skin test doses of toxin; also in ten immunization packages of six 10 cc. vials containing, respectively, 500, 2,00p, 8,000, 25,000 80,000 and 80,000 skin test doses of toxin per cubic centimeter. Modified Bacterial Toxin DIPHTHERIA TOXOID. — Anatoxin-Ramon. — Diph- theria Prophylactic. — "A sterile aqueous solution of the prod- ucts of growth of the diphtheria bacillus (Corynehacterium diphtheriae) so modified by special treatment as to have lost the ability to cause toxic effects in guinea-pigs but retaining the property of inducing active immunity. The toxicity of the Diphtheria Toxoid shall be so low that five times the dose for the human adult does not cause either local or general symptoms of diphtheria poisoning in a guinea-pig within thirty days after its injection into the animal. The antigenic value shall be such that the initial dose for the human shall protect at least 80 per cent of guinea-pigs, six weeks after injection, against five minimum lethal doses each of diphtheria test toxin. Some specimens are concentrated and purified by precipitating and washing the active portion of the detoxified material. Such concentrated and purified specimens must be capable, when injected into guinea-pigs, of inducing the production of diph- theria antitoxin of such potency as is prescribed by the National Institute of Health of the United States Public Health Service." US.P. For standards see the U. S. Pharmacopeia under Toxinum Diphthericum Detoxificatum. Actions, Uses and Dosage. — Diphtheria toxoid is used for active immunization against diphtheria. It is administered sub- cutaneously, preferably at the insertion of the deltoid, in two or three doses with an interval of three or four weeks between doses. Since some local and general reactions have been observed in adults and in children over 8 years of age, an intracutaneous test dose of 0.1 cc. of the toxoid diluted (1 in 20) with physiological saline solution should be given to determine sensitivity in such persons. Cutter Laboratories, Berkeley, Calif. Diphtheria Toxoid-Cutter. — Prepared from diphtheria toxin whose L4- dose is 0.2 cc. or less by treatment with 0.3 to 0.4 per cent formaldehyde at a temperature of from Z7 to 40 C. until its toxicity is so reduced that injection of five maximum human doses into guinea-pigs causes no local or general symptoms of diphtheria poisoning. The product is tested for antigenic potency by injection into at least ten guinea-pigs of one human dose each; if at the end of six weeks at least 80 per cent of the anirnals survive for ten days the injection of five minimum lethal doses of diph- theria toxin, the toxoid is considered satisfactory. It is marketed in packages of one immunization treatment of two 1 cc. vials; in packages of ten immunization treatments of twenty 1 cc. vials, and in packages of one thirty cc. vial, fifteen immunization treatments. The Gilliland Laboratories, Inc., Marietta, Pa. Diphtheria Toxoid-Gilliland. — Prepared from diphtheria toxin whose L-f dose is 0.20 cc. or less by treatment with formaldehyde at a tem- perature of from 38 to 40 C. until its toxicity is so reduced that injection SERUMS AND VACCINES 399 of five maximum human doses into guinea-pigs causes no local or general symptoms of diphtheria poisoning. The product is tested for antigenic potency by injection into at least ten guinea-pigs of one human dose each; if at the end of six weeks at least 80 per cent of the animals survive for ten days the injection of five minimum lethal doses of diphtheria toxin, the toxoid is considered satisfactory. Marketed in packages of one immunization treatment of two 1 cc. vials; in packages of ten immunization treatments of twenty 1 cc. vials; and in packages of fifteen immunization treatments of one 30 cc. vial. Each package is accompanied by a sufficient amount of diluted diphtheria toxoid for the reaction test. Hixson Laboratories, Inc., Johnstown, Ohio. Diphtheria Toxaid. — Prepared from diphtheria toxin by treatment with 0.4 per cent solution of formaldehyde at a tempertaure of 40 C. until its toxicity is so reduced that 5 cc. will not cause early or late symptoms of diphtheria poisoning in a guinea-pig under observation for thirty-five days. The product is tested for antigenic potency by injecting guinea- pigs with varying doses and testing the resistance of these guinea-pigs to five minimum lethal doses of diphtheria toxin given six weeks after the dose of toxoid. If 80 per cent of these pigs survive for ten days, the product is considered satisfactory. Merthiolate 1: 10,000 is used as pre- servative. Marketed in packages of two 1 cc. vials, in packages of twenty 1 cc. vials, in packages of one 10 cc. vial, and in packages of one 30 cc. vial. All packages are accompanied by vials containing diluted toxoid for carrying out reaction tests. Lederle Laboratories, Inc., Pearl River, New York. Diphtheria Toxoid. — Prepared from diphtheria toxin of which the L-f dose is 0.2 cc. or less. The toxin is treated with formaldehyde at a tem- perature of 37 to 40 C. until the injection of five human doses into six 300 Gm. guinea-pigs will cause no signs of diphtheria poisoning, includ- ing paralysis at any time during a period of thirty days. It is tested for antigenic power by injecting subcutaneously at least ten guinea- pigs weighing from 270 to 320 Grn. each with the initial human dose; at the end of six weeks each animal is injected subcutaneously with 5 M. L. D. of a stable diphtheria toxin; at least 80 per cent of the animals must survive for ten days. The finished product is adjusted to contain in 2 cc. enough of the toxoid for one immunization treatment. It is marketed in packages of one immunization treatment consisting of two 1 cc. vials of diphtheria toxoid; in packages of fifteen immunization treatments consisting of one 30 cc. vial of diphtheria toxoid; in packages of one vial containmg sufficient diluted diphtheria toxoid for ten tests, and in packages of one vial containing sufficient diluted diphtheria toxoid for one hundred tests. Eli Lilly & Co., Indianapolis. Diphtheria Toxoid. — Prepared from diphtheria toxin by treatment with 0.3 per cent solution of formaldehyde at a temperature approximately 40 C. until its toxicity is so reduced that 5 cc. will not cause early or late symptoms of diphtheria poisoning in a 300 gram guinea-pig. The product is tested for antigenic efficiency by injecting the initial human dose into a large series of guinea-pigs; if at the end of six weeks at least 80 per cent of these animals survive the injection of five minimum lethal doses of diphtheria toxin for ten days, the product is considered satis- factory. Merthiolate 1:10,000 is used as preservative. Marketed in packages of one immunization treatment consisting of two 1 cc. vials of diphtheria toxoid, and in packages of fifteen immunization treatments consisting of one 30 cc. vial of diphtheria toxoid. Wm. S. Merrell Co., Cincinnati. Diphtheria Toxoid. — Prepared from diphtheria toxin the L+ dose of which is 0.2 cc. or less by treatment with formaldehyde solution at a temperature of from _ 38 to 40 C. until its toxicity is so reduced that injection of five maximum human doses into guinea-pigs causes no local or general symptoms of diphtheria poisoning. The product is tested for antigenic potency by injection into at least ten guinea-pigs of one human 400 NEW AND NONOFFICIAL REMEDIES dose each; if at the end of six weeks at least 80 per cent of the animals survive for ten days the injection of five minimum lethal doses of diph- theria toxin, the toxoid is considered satisfactory. Marketed in packages of two 1 cc. vials, and in packages of fifteen immunization treatments of one 30 cc. vial. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Diphtheria Toxoid. — Prepared from broth cultures of diphtheria toxin having an L+ dose of 0.25 cc. or less, diluted with physiologic solution of sodium chloride and free of serum proteins. Diphtheria toxin is treated with formaldehyde at a temperature of from 30 to 40 C. until its toxicity is so reduced that 5 cc. will not cause acute death in a guinea-pig. It is tested for antigenic power by injecting guinea-pigs with varying doses and testing the resistance of these guinea-pigs to five fatal doses of diph- theria toxin given six weeks after the dose of toxoid. The dose which induces sufficient antigenic response to assure survival of 80 per cent of these animals for ten days is the lowest permissible human dose. The finished product contains two such doses per cubic centimeter. It must be so free from toxicity that five human doses cause no symptoms of poison- ing in a guinea-pig. It is marketed in packages of one immunizing treat- ment containing two 1 cc. vials of diphtheria toxoid and in packages of ten immunizing treatments containing twenty 1 cc. vials of diphtheria toxoid; also in packages of fifteen immunizing treatments containing one 30 cc. vial of diphtheria toxoid. The National Drug Co., Philadelphia. Diphtheria Toxoid.— Prepared from seven day cultures of the diphtheria bacillus that yield a toxin having an L+ dose of not more than 0.2 cc. The toxin is treated with formaldehyde until its toxicity is so reduced that five human doses will cause no local or general symptoms of diphtheria poisoning when injected subcutaneously into guinea-pigs. The product is tested for antigenic potency by injection subcutaneously of one human dose of the toxoid into each of at least ten guinea-pigs weighing between 270 and 320 Gm.; at the end of six weeks the animals are injected sub- cutaneously with five minimum lethal doses of a stable diphtheria toxin; 80 per cent of the animals must survive for ten days. For the two dose method of treatment the following forms are marketed: packages of one immunization treatment, consisting of two vials, each containing one human dose; packages of ten immunization treatments, consisting of one vial containing twenty human doses; packages of fifteen immunization treatments, consisting of one vial containing thirty human doses; in packages of five immunization treatments, consisting of one vial, contain- ing ten human doses, and in packages of ten immunization treatments, consisting of twenty 1 cc. vials, each containing one human dose. For determining sensitivity to diphtheria toxoid the product is sup- plied in the form of a 1:20 dilution. The test dose is 0.1 cc. injected intradermally. Supplied in packages of five and fifty tests. Parke, Davis & Co., Detroit. Diphtheria Toxoid.— Frepzred from diphtheria toxin of which the L-f- dose is 0.25 cc. The toxin is treated with formaldehyde according to the specifications of the U. S. Public Health Service until it is detoxified so that 5 cc. (five minimum human doses) injected into 300 gram guinea-pigs will not produce signs of toxic poisoning. It is tested for antigenic power by subcutaneous injection of 0.5 cc. into ten 300 gram guinea-pigs. After six weeks the animals are injected with five M. L. D. of diphtheria toxin and the product is considered satisfactory if 80 per cent survive for ten days. Diphtheria toxoid-P. D. & Co. is marketed in packages contain- ing one bulb (0.5 cc.) of dilute diphtheria toxoid for the reaction test and two bulbs (0.5 and 1.0 cc, respectively) of diphtheria toxoid. Also marketed in hospital packages of one vial containing 30 cc. of diphtheria toxoid. For determining sensitivity to the nonantigenic portion of diphtheria toxoid, a diluted diphtheria toxoid is supplied. This is marketed in SERUMS AND VACCINES 401 packages of one 0.5 cc. vial and in packages of one 5 cc. vial contain- ing diluted diphtheria toxoid sufficient for five and fifty reaction tests, respectivel}'. Dosage. — For the reaction test, 0.1 cc. of dilute diphtheria toxoid intra- dermally, for immunization, two doses (0.5 and 1.0 cc.) of the diphtheria toxoid subcutaneously, with an interval of three or four weeks between injections, E. R. Squibb & Sons, New York. Diphtheria Toxoid-Squibh. — Prepared from diphtheria toxin by treat- ment with formaldehyde as prescribed by the U. S. Public Health Service to secure detoxification, which is tested by injection of five maximum human doses into guinea-pigs weighing 300 grams. The product is tested for antigenic potency by injection into at least ten guinea-pigs of one human dose each; if at the end of six weeks at least 80 per cent of the animals survive for ten days the injection of five minimum lethal doses of diphtheria toxin, the toxoid is considered satisfactory. Diphtheria toxoid- Squibb is standardized to contain in 2 cc. enough of the toxoid for one immunization treatment. It is marketed in packages of one immunization treatment containing two 1 cc. ampules of diphtheria toxoid and in packages of one 30 cc. vial of diphtheria toxoid. Also _ marketed in packages of one vial containing 1 cc. of diluted diphtheria toxoid for the reaction test. United States Standard Products Company, Woodworth, Wis. Diphtheria Toxoid-U. S. S. P. Co. — Prepared from diphtheria toxin whose L + dose is 0.2 cc. or less by treatment with 0.3 to 0.4 per cent formaldehyde at a temperature of from 37 to 40 C. until its toxicity is so reduced that injection of five human doses into guinea-pigs causes no local or general symptoms of diphtheria poisoning. The product is tested for antigenic potency by injection into at least ten guinea-pigs of one human dose each; if at the end of six weeks at least 80 per cent of the animals survive for ten days the injection of five minimum lethal doses of diph- theria toxin, the toxoid is considered satisfactory. The product is stand- ardized to contain in 2 cc. enough of the toxoid for one immunization treatment. Marketed in packages of two 1 cc. vials; in packages of twenty 1 cc. vials; in packages of one 6 cc. vial; in packages of one 20 cc. vial; and in packages of one 30 cc. vial. DIPHTHERIA TOXOID, ALUM PRECIPITATED (REFINED).— Diphtheria Toxoid.-— It has been shown that toxin of the diphtheria bacillus, B. diphtheriae (C. diphfheriae) modified by the method of Ramon may be precipitated by the addition of potassium aluminum sulfate. The resultant water- insoluble precipitate which contains the antigenic properties is purified by washing. More than 50 per cent of the proteins contained in the original crude toxoid are removed during the process of purification. Actions, Uses and Dosage. — Refined diphtheria toxoid, alum precipitated is used for active immunization against diphtheria. It is administered subcutaneously, preferably at the insertion of the deltoid muscle, in one dose. Due to the presence of potassium aluminum sulfate in the product, absorption is delayed. A nodule persists at the site of inoculation for several days, and occasionally an abscess forms. Cutter Laboratories, Berkeley, Calif. Diphtheria Toxoid, Alum Precipitated, Refined. — Prepared from diph- theria toxin having an L-f dose of 0.20 cc. or less. The toxin is treated with from 0.3 to 0.4 per cent formaldehyde at a temperature of 402 NEW AND NONOFFICIAL REMEDIES from 38 to 40 C. until the toxicity is so reduced that the injection of five human doses into a guinea-pig will produce no symptoms of local or general diphtheria poisoning. The toxoid is precipitated by the addition of not more than 2 per cent of potassium aluminum sulfate. The precipitate is washed twice with physiologic solution of sodium chloride and resuspended in physiologic solution of sodium chloride to a volume not less than the volume of the original toxoid. Merthiolate 1 : 10,000 is added as a preservative. The product is tested for potency according to the method prescribed by the National Institute of Health: guinea-pigs weighing 500 Gm., given one human dose, rtiust develop within six weeks at least two units of diphtheria antitoxin per cubic centimeter of blood serum. Marketed in packages of 1 cc. (one immunizing treat- ment) and in packages of one 10 cc. vial (ten immunizing treatments). The Gilliland Laboratories, Inc., Marietta, Pa. Diphtheria Toxoid, Alum Precipitated (Refined). — Prepared from a veal broth culture of B. diphtheriae (C. diphtheriae) which yields toxin having an L+ dose of not more than 0.2 cc. The toxin is treated with 0.4 per cent U. S. P. formaldehyde until the toxicity is so reduced that five human doses will cause no local or general symptoms of diphtheria poison- ing when injected subcutaneously into guinea-pigs weighing 300 Gm. The toxoid is precipitated with a solution of aluminum and potassium sulfate. The precipitate is washed and then suspended in physiologic solution of sodium chloride. The finished product contains merthiolate in a concen- tration of 1: 10,000. The product is tested for antigenic potency accord- ing to the method prescribed by the National Institute of Health: guinea- pigs weighing 500 Gm., given one human dose, must produce at the end of six weeks at least two units of diphtheria antitoxin in each cubic centi- meter of blood serum. Marketed in packages of one 1 cc. vial (one immunization); ten 1 cc, vials (ten immunizations); one 10 cc. vial (ten immunizations). Hixson Laboratories, Inc., Johnstown, Ohio. Diphtheria Toxoid, Alum Precipitated (Refined). — Prepared from diph- theria toxin having an L+ dose of 0.20 cc. or less and an M. L. D. value of 0.0025 cc. The toxin is treated with formaldehyde at a tem- perature of from 38 to 40 C. until its toxicity is so reduced that five human doses will cause no local or general symptoms of diphtheria poisoning when injected subcutaneously into guinea-pigs under observa- tion for thirty days. The toxoid is precipitated with a solution of aluminum and potassium sulfate in such amount that the finished product shall not contain more than 20 mg. of alum per human dose. The super- natant solution is siphoned off and discarded. The precipitate is washed three times with sterile physiologic solution of sodium chloride and resuspended in sterile physiologic solution of sodium chloride so that the final volume is equal to that of the original toxoid. The finished product contains 1 : 10,000 merthiolate as a preservative. The immunizing value of the diphtheria toxoid-alum precipitated is determined according to the regulations of the National Institute of Health; namely, the human dose administered subcutaneously to at least four guinea-pigs weighing 500 Gm. produces at least two units of antitoxin per cubic centimeter of blood serum at the end of four weeks. Marketed in packages of one 1 cc. vial (one immunization), ten 1 cc. vials (ten immunizations) and one 10 cc. vial (ten immunizations). Jensen-Salsbery Laboratories, Inc., Kansas City, Mo. Diphtheria Toxoid, Alum Precipitated (Refined). — Prepared from diphtheria toxin having an M. L. D. value of 0.0025 cc. or less. The toxin is treated with formaldehyde until its toxicity is so reduced that five human doses will cause no local or general symptoms of diphtheria poisoning when injected subcutaneously into guinea-pigs. The toxoid is precipitated by the addition of not more than 2 per cent of potassium aluminum sulfate; the precipitate is washed with physiologic solution of sodium chloride and resuspended in a volume of physiologic solution of sodium chloride equivalent to the volume of the original toxoid. Merthiolate, 1: 10,000, is added as a preservative. The product is tested SERUMS AND VACCINES 403 for antigenic potency acording to the method prescribed by the National Institute of Health: guinea-pigs weighing 500 Gm., given one human dose, must produce at the end of six weeks at least two units of diph- theria antitoxin in each cubic centimeter of blood. Marketed in packages of 1 cc. (1 immunizing treatment) and in pack- ages of ten 1 cc. vials (10 immunizing treatments). Lederle Laboratories, Inc., Pearl River, N. Y. Refined Diphtheria Toxoid (Alum Precipitated)-Lederle. — Diphtheria toxin, the L-f dose of which is 0.2 cc. or less, is detoxified with 0.2 to 0.4 per cent solution of formaldehyde to make diphtheria toxoid. The native toxoid is concentrated by ultrafiltration against the membrane which passes peptones and other extractives but retains the toxoid. When the toxoid is essentially free from membrane-passing substances, it is diluted with buffered saline solution so that each cubic centimeter contains approxi- mately 45 flocculating units (Ramon). The solution is then brought to a reaction of pn 8.3 and precipitation is effected with a 4 per cent solution of potassium aluminum sulfate; it is washed with sterile physiological solution of sodium chloride and resuspended in the same menstruum. It is preserved with Merthiolate 1: 10,000. The product is tested for anti- genic potency according to the method prescribed by the National Institute of Health: each of four guinea-pigs, weighing 500 Gm., are given one human dose subcutaneously. At the end of six weeks the pooled serum must show at least two units of diphtheria antitoxin in each cubic centimeter of blood. Marketed in packages of one 1 cc. vial (one immunization), ten 1 cc. vials (ten immunizations), and one 10 cc vial (ten immunizations); also marketed in packages of one 0.5 cc. vial (one immunization), ten 0.5 cc. vials (ten immunizations), and one 5 cc. vial (ten immunizations). Lee Laboratories, Columbus, Ohio. Diphtheria Toxoid, Alum Precipitated, Refined. — Diphtheria toxins are filtered free from the bacterial cells, treated with 0.4 per cent solution of formaldehyde, and incubation is carried out at 38 to 40 C. for from four to seven weeks in order to destroy all toxicity. The absence of toxicity is determined by an intracutaneous test on guinea-pigs and by the injection of 5 cc. subcutaneously into guinea-pigs. The skin tests shall show no reaction in from forty-eight to seventy-two hours, and the pigs receiving 5 cc. shall show no symptoms of diphtheritic poisoning within a five weeks period. After the toxins are shown to be completely detoxified and sterile, they are precipitated with a 2 per cent solution of alum and allowed to settle. The supernatant liquid is siphoned off and the precipitate washed with sterile physiologic solution of sodium chloride. This washing process is repeated three times. The final volume is then made up to the original volume of the toxin, and merthiolate 1: 5,000 is added as a preservative. The regulations of the National Institute of Health are adhered to in checking the immunizing value of every batch: pigs are injected sub- cutaneously with 1 cc. of the alum precipitated diphtheria toxoid. At the end of six weeks they are bled, and their serum must show at least 2 units of diphtheria antitoxin per cubic centimeter. Marketed in pack- ages of one 1 cc. vial, ten 1 cc. vials, and one 10 cc. vial, representing respectively one, ten and ten immunizing doses. Eli Lilly & Co., Indianapolis. Diphtheria Toxoid, Alum Precipitated (Refined)-Lilly. — Prepared from diphtheria toxin by treatment with formaldehyde and precipitated with alum, washed, and resuspended in physiologic solution of sodium chloride. The product is tested for antigenic efficiency as prescribed by the National Institute of Health: guinea-pigs weighing 500 Gm. given one human dose, must produce at the end of six weeks at least two units of diph- theria antitoxin in each cubic centimeter of blood. It is marketed in packages of one immunization treatment, containing one 0.5_ cc. vial, and in packages of ten immunizations, containing one 5 cc. vial of the refined toxoid. 404 NEW AND NONOFFICIAL REMEDIES Wm. S. Merrell Co., Cincinnati. Diphtheria Toxoid, Alum Precipitated (Refined). — Prepared from diph- theria toxin the L-f dose of which is less than 0.2 cc. The toxin is detoxified with an appropriate amount of formaldehyde solution so that the injection of five human doses, subcutaneously, into guinea-pigs causes neither general nor local symptoms of diphtheria poisoning. The toxoid is refined by precipitation with a sterile solution of potassium aluminum sulfate. The precipitate is then washed with sterile physiologic solution of sodium chloride and resuspended in sufficient physiologic solution of sodium chloride to bring its volume to that of the toxoid from which the precipitate was prepared. The finished product is preserved with merthio- late, 1: 10,000, and contains less than 2 per cent of alum. The product is tested for antigenic potency by the method prescribed by the National Institute of Health: the human dose must produce in guinea-pigs within six weeks at least two units of diphtheria antitoxin per cubic centimeter of blood serum. It is marketed in packages of one 1 cc. vial (one immunization) and one 10 cc. vial (ten immunizations). Also marketed in packages of ten 1 cc. vials (ten immunizations). The National Drug Co., Philadelphia. Refined Diphtheria Toxoid (Alum Precipitated). — Prepared from a seven day culture of the diphtheria bacillus which yields toxin having an L+ dose of not more than 0.2 cc. The toxin is treated with formal- dehyde until its toxicity is so reduced that five human doses will cause no local or general symptoms of diphtheria poisoning when injected subcutaneously into guinea-pigs. The toxoid is precipitated with a solution of alum, washed, and then suspended in physiologic solution of sodium chloride to which merthiolate has been added. The product is tested for antigenic potency according to the method prescribed by the National Institute of Health: guinea-pigs, weighing 500 Gm., given one human dose, must produce at the end of six weeks at least two units of diphtheria antitoxin in each cubic centimeter of blood. Marketed in packages of one 0.5 cc. vial, one 5 cc. vial ajid ten 0.5 cc. vials, representing, respectively, one, ten and ten immunizing doses. Parke, Davis & Company, Detroit. Diphtheria Toxoid, Alum Precipitated (Refined)-P. D. & Co. — Pre- pared by detoxifying diphtheria toxin of 0.1 L+ dose with a 0.4 per cent solution of formaldehyde, adding to the resultant toxoid sufficient potassium aluminum sulfate to make a solution of 2 per cent, washing the precipitate with physiologic solution of sodium chloride and suspend- ing in a sufficient amount of physiologic solution of sodium chloride to bring it back to the original volume, the finished product to contain one human dose in 0.5 cc. and/or in 1 cc. The finished product is preserved with sodium ethyl mercuric-thiosalicylate 1:10,000 (merthiolate). It is standardized according to the requirement of the National Institute of Health: guinea-pigs weighing 500 Gm. given one human dose must produce at the end of six weeks at least two units of diphtheria anti- toxin in each cubic centimeter of blood. If the 0.5 cc. dose of the toxoid produces two units of antitoxin in the test animals, it is used for the 0.5 cc. product; if a 1 cc. dose of the toxoid is necessary to produce two units of antitoxin in the test animals, the product is classified as a 1 cc. dose product. Marketed in packages of one 1 cc. vial and in packages of one 10 cc. vial containing one and ten doses, respectively. It is supplied on request in packages of one 0.5 cc. vial and in packages of one 5 cc. vial con- taining one and ten doses, respectively. Also marketed in packages of one 0.5 cc. vial, and in packages of one 5 cc. vial containing one and ten doses, respectively. SERUMS AND VACCINES 405 E. R. Squibb & Sons, New York. Refined Diphtheria Toxoid Alum Precipitated-Squibh. — Prepared by treating diphtheria toxoid with a solution of alum until complete pre- cipitation is produced. The precipitate is washed with and suspended in physiologic solution of sodium chloride. The product is tested for antigenic activity according to the method prescribed by the National Institute of Health: guinea-pigs, weighing 500 Gm., given one human dose, must produce at the end of six weeks at least two units of diphtheria antitoxin in each cubic centimeter of blood. Marketed in packages of one 0.5 cc. vial and in packages of one 5 cc. vial, representing one and ten immunizing doses, respectively; in packages of ten 0.5 cc. vials, representing ten immunizing doses; also marketed in packages of one 1 cc. vial, in packages of ten 1 cc. vials and in packages of one 10 cc. vial, representing one, ten and ten immunizing doses respectively. United States Standard Products Company, Woodworth, Wis. Diphtheria Toxoid, Alum Precipitated, Refined. — Prepared by treating diphtheria toxin with 0.3 to 0.4 per cent formaldehyde at temperatures of from 35 to 40 C. until its toxicity is reduced to the point where five human doses, injected into a guinea-pig, produce no symptoms of diph- theria poisoning. The toxoid is treated with a 4 per cent solution of potassium aluminum sulfate, the total amount of which is not to exceed 20 mg. per human dose of the finished product. The resulting precipitate is washed with sterile physiologic solution of sodium chloride and resuspended in physiologic solution of sodium chloride to which merthio- late (1:10,000) has been added. The product is tested for antigenic potency according to the method prescribed by the National Institute of Health: guinea-pigs, weighing 500 Gm., given one human dose, must produce at the end of six weeks at least two units of diphtheria antitoxin in each cubic centimeter of blood. Marketed in packages of one 1 cc. vial (one immunizing dose) ; in packages of ten 1 cc. vials (ten immunizing doses) ; and in packages of one 10 cc. vial (ten immunizing doses). STAPHYLOCOCCUS TOXOID.— Staphylococcus Ana- toxin. — Univalent or polyvalent, potently hemolytic and der- monecrotic toxins of Staphylococcus aureus and alhus altered by the formaldehyde-detoxifying process of Burnet (modified from Ramon). Antigenicity is maintained but toxicity is greatly diminished. Actions, Uses and Dosage. — Staphylococcus toxoid has been reported a valuable agent in the prophylaxis and therapy of various staphylococcic pyodermas and localized pyogenic proc- esses due to Staphylococcus aureus and alhus (boil, carbuncle, furunculosis, acne, and so on). The toxoid is said to be effec- tive in producing active immunity to the dermonecrotic and hemolytic elements of the toxins of Staphylococcus aureus and alhus', irrespective of the individual strain of the infecting organ- ism. The toxoid induces the production of staphylococcus anti- toxin in the blood serum of immunized persons. Treatment consists in the subcutaneous or intramuscular injection at two to seven day intervals of an amount of toxoid representing the following dermonecrotizing doses of toxin (a dermonecrotizing dose is the least amount of toxin which on intradermal injec- 406 NEW AND NONOFFICIAL REMEDIES tion will produce an erythema with central necrosis at least 5 by 5 mm. in diameter) : First injection 20 doses Second injection 40 doses Third injection 60 doses Fourth injection 80 doses Fifth injection 100 doses Sixth injection 200 doses Seventh injection 400 doses Eighth injection 600 doses Ninth injection 800 doses Tenth injection 1,000 doses Following the completion of the tenth injection, subsequent treatment, if necessary, may be maintained at that dosage or increased as the progress of the individual case may indicate. Lederle Laboratories, Inc., Pearl River, N. Y. Staphylococcus Toxoid-Lederle. — Prepared by treating a staphylococcus toxin filtrate with 0.3 per cent solution of formaldehyde and storing at 37-38 degrees C. until 0.1 cc. injected intraderraally into previously tested rabbits produces no evidence of necrosis. The product is then diluted with 0.25 per cent peptone solution so that two strengths are obtained: Dilution No. 1, containing in each cubic centimeter the toxoid obtained from 100 necrotizing doses of toxin; and Dilution No. 2, containing in each cubic centimeter the toxoid obtained from 1,000 necrotizing doses of toxin. The material is then preserved with merthiolate 1:10,000. The usual sterility tests prescribed by the National Institute of Health are made. Safety tests are made by injecting 1 cc. doses into each of two mice. The potency of the original toxin is tested by making serial dilu- tions and injecting 0.1 cc. of each dilution intracutaneously irito sus- ceptible rabbits in order to determine the maximum dilution which will cause necrosis. The least amount of toxin which produces an area of erythema with a central necrosis at least 5 mm. in diameter is taken as one necrotizing dose of toxin. Staphylococcus Toxoid-Lederle is marketed in packages of one 5 cc. vial, each cubic centimeter containing the toxoid derived from 100 necro- tizing doses of toxin; and in packages of one 5 cc. vial, each cubic centimeter containing the toxoid derived from 1,000 necrotizing doses of toxin. TETANUS TOXOID, ALUM PRECIPITATED.— Tetanus Anatoxin. — A preparation of tetanus toxin after the formaldehyde detoxifying procedure of Ramon whereby the toxic action is greatly diminished with no loss of antigenic potency. Alum precipitation furthers this action by freeing the antigenic substance from the reaction-producing proteins of the culture medium. Actions, Uses and Dosage. — Tetanus toxoid is recommended for the production of active immunity to tetanus. The recom- mended human dose (1.0 cc. or 0.5 cc.) is injected subcutane- ously, preferably in the region of the deltoid. Approximately three months later the second and final injection is given. The immunity thus produced is reasonably persistent. However, it has been shown that, if some time after the original immuniza- SERUMS AND VACCINES 407 tion a single injection of toxoid is given, there results a prompt (within two weeks) and marked rise in the antitoxic titer of the serum. Thus, in cases of injury to persons previously immunized, an injection of tetanus toxoid may suffice to protect against tetanus in place of the usual tetanus antitoxin. It should be borne in mind that in these cases several weeks is required, following the second injection of toxoid, before immunity may be assumed to be well established. Therefore, in any dubious instance the conservative course is the administration of anti- toxin. Active immunization to tetanus would appear to be a desirable procedure in the case of individuals whose work sub- jects them to a greater than normal hazard of the disease. The National Drug Co., Philadelphia. Refined Tetanus Toxoid (Alum Precipitated). — Marketed in packages of two 1 cc. vials (one immunization treatment) ; and in packages of one 10 cc. vial (five immunization treatments). Lederle Laboratories, Inc., Pearl River, N. Y. Refined Alum Precipitated Tetanus Toxoid-Lederle. — Marketed in pack- ages of two 1 cc. vials (one complete immunization) ; and in packages of one 10 cc. vial (five complete immunizations). BACTERIAL VACCINES Bacteral vaccines, or bacterins, are suspensions of killed bacteria in physiologic solution of sodium chloride, usually with the addition of some preservative such as cresol, phenol or glycerin. The therapeutic use of stock bacterial vaccines rests on uncer- tain clinical evidence. The dosage and intervals for bacterial vaccine treatment can- not be stated definitely. In general, the severer the disease, the smaller the dose should be ; and the smaller the doses, the shorter the intervals. In mild afTections no improvement may result until the vaccine is pushed to a systemic reaction. Prophylactically, the typhoid and paratyphoid vaccines appar- ently have proved of great value. Plague and cholera vaccines are also used in prophylaxis. ACNE BACILLUS VACCINE.—Vaccinum Acne.— Prepared from the acne bacillus of Unna and Sabouraud, B. acnes (Corynebacteriiim acnes). Actions and Uses. — The acne bacillus is not found in all cases of acne ; but in those cases in which the bacillus is found (acne vulgaris) it seems to be the active pathogenic agent and the use of acne vaccine may give good results, especially in the cystic form and in acne indurata. In other cases, the staphy- lococcus is responsible for the inflammation, and the corre- sponding staphylococcus vaccine or toxoid may be tried. Cutter Laboratories, Berkeley, Calif. Acne Bacillus Vaccine. — Each cubic centimeter contains 50 million killed acne bacilli suspended in physiological solution of sodium chloride. Marketed in 5 cc. vial packages. Dosage. — From 5 to 50 million killed bacteria. 408 NEW AND NONOFFICIAL REMEDIES Lederle Laboratories, Pearl River, N. Y. Acne Vaccine. — Marketed in packages of one 5 cc. vial containing 40 million killed acne bacilli per cubic centimeter. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Acne Bacterin. — Marketed in packages of four syringes, containing, respectively, 25 million, 50 million, 100 million and 200 million killed acne bacilli; also marketed in 5 cc. vials, containing 200 million killed bacilli per cubic centimeter. Dosage. — Initially, from 5 to 25 million. E. R. Squibb & Sons, New York. Acne Vaccine. — Marketed in vials of 5 cc. and 20 cc, each cubic centi- meter containing 1,000 million killed bacilli. BRUCELLA MELITENSIS VACCINE.— A bacterial vaccine obtained from Brucella mclitcnsis (var. abortus, var. siiis, and var. melitensis). Actions and Uses. — Brucella melitensis vaccine is proposed for use in the treatment of undulant fever. Jensen-Salsbery Laboratories, Inc., Kansas City, Mo. Undulant Fever Bacterial Vaccine. — A heat killed suspension in physiologic solution of sodium chloride of Brucella melitensis, var. abortus and var. suis (bovine type, 50 per cent; porcine type 50 per cent), pre- served with 0.5 per cent of phenol. Each cubic centimeter contains six billion killed organisms. The product is prepared bj' growing the organ- isms on nutrient agar for forty-eight hours; the growth is washed off with physiologic solution of sodium chloride and maintained at a tem- perature of 60 C. for forty minutes. The usual sterility tests prescribed by the U. S. government are made. Safety tests are made on the stock vaccine by the inoculation of rabbits. No potency tests are made. Purity of cultures is determined by the study of colony formation, carbohydrate reactions, and the agglutination test with specific serum. The product is marketed in packages of six 1 cc. vials. Dosage. — Initially, 0.25 cc, repeated daily with increase of 0.25 cc. until 1 cc. is given; this is continued according to the indications of the case. After a maximum of seven doses has been given, a period_ of from two to three weeks should be permitted to elapse, after which, treatment may be resumed should it be required. Lederle Laboratories Inc., Pearl River, N. Y. Brucella Melitensis Vaccine-Lederlc. — A heat killed suspension of Brucella melitensis (abortus and suis) organisms (2,000 million per cubic; centimeter) prepared by using equal parts of bovine and porcine strains. Both strains were isolated from humans exhibiting typical, and clinically active, cases of undulant fever. The vaccine is preserved with 0.5 per cent phenol. The usual sterility tests prescribed by the-U. S. govern- rnent are made, and in addition blood agar streaks are made of the heat killed stock vaccine before the addition of phenol. Safety tests are made by injecting white mice with 1 cc. of stock vaccine diluted with three parts of physiological so'lution of sodium chloride: two mice are used for each stock bottle, and they are observed for two weeks. No potency tests are made. Purity of cultures is observed by agglutination test with specific antiserums and also by fermentation reaction with various sugars. The product is marketed in packages of one 5 cc. vial. Dosage. — The subcutaneous injection at three day intervals of two 0.25 cc. doses, two 0.5 cc. doses, and repeated injections of 1 cc. doses until in all about 10 cc. has been administered. SERUMS AND VACCINES 409 The National Drug Co., Philadelphia. Undiilant Fever Vaccine. — A heat killed suspension of Brucella organ- isms (2,000 million per cubic centimeter) merthiolate 1:10,000 is used as perservative. The usual sterility tests prescribed by the U. S. govern- ment are made, and in addition blood agar streaks are made of the heat killed stock vaccine before the addition of the merthiolate. Safety tests are made on the stock vaccine by injecting guinea-pigs with the maximum human dose, 1 cc. No potency tests are made. Purity of cultures is determined by the study of colony formation, carbohydrate reactions, and agglutination test vi'ith specific serum. The product is marketed in pack- ages of one 5 cc. vial, in packages of one 15 cc. vial, and in packages of one 30 cc. vial. Dosage. — The subcutaneous injection at seven to ten day intervals of doses of 0.25 cc, 0.5 cc. and 1 cc, respectively, is recommended. CHOLERA VACCINE. — Vaccinum Cholerae.— Pre- pared from killed cholera vibrios, V. cholerae (V. comma). Actions and Uses. — Cholera vaccine has been used as a pro- phylactic with favorable results reported. Lederle Laboratories, Pearl River, N. Y. Cholera Vaccine (Prophylactic). — Marketed in packages of two 1 re. vials containing, respectively, 4,000 and 8,000 million killed cholera vibrios. Eli Lilly & Co., Indianapolis. Cholera Vaccine, Prophylactic. — Marketed in packages of three 1 cc vials, one containing 500 million killed cholera vibrios per cubic centi- meter, and the second and third vials each containing 1,000 million killed cholera vibrios per cubic centimeter; in packages of ten 2.5 cc. vials each containing 1,000 million killed cholera vibrios per cubic centi- meter. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Cholera Bacterin (Cholera Vaccine). — Marketed in packages of three syringes each, the first containing 500 million killed cholera vibrios, while the second and third each contains 1,000 million killed vibrios; also marketed in packages of one 20 cc. vial containing 1,000 million killed cholera vibrios per cubic centimeter. PLAGUE BACILLUS VACCINE.— Vaccinum Pestis. — Made from Bacillus pestis (Pasteiirella pestis). Actions and Uses. — Vaccine has been used for the prevention of plague with results that appear to justify its use. No prac- tical application has been made of vaccine treatment in plague. Lederle Laboratories, Inc., Pearl River, N. Y. Plague Vaccine (Prophylactic). — Marketed in 1 cc. vials containing 5,000 million killed plague bacilli; also in 10 cc. vials containing 5,000 million killed plague bacilli per cubic centimeter. Eli Lilly & Co., Indianapolis. Plague Vaccine, Prophylactic. — Marketed (for double vaccination) in single immunization packages of two 1 cc. vials containing, respectively, 1.000 and 2,000 million killed plague bacilli per cubic centimeter; also in packages of ten 1.5 cc. vials containing 2,000 million killed plague 410 NEW AND NONOFFICIAL REMEDIES bacilli per cubic centimeter. Plague vaccine (for single vaccination) is sup- plied in one 20 cc. vial containing 5,000 million killed plague bacilli per cubic centimeter (twenty complete immunizations) and in packages of three 1 cc. vials, each containing 5,000 million killed plague bacilli per cubic centimenter (three complete immunizations). Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Plague Bacterin. — Marketed as follows: (1) in packages of one 1 cc. vial (for single vaccination), containing 5,000 million killed plague bacilli; (2) in packages of one 10 cc. vial (for ten vaccinations), con- taining 5,000 million killed plague bacilli per cubic centimeter; (3) in "double vaccination" packages of two 1 cc. vials, both doses to be used for one immunization, the first dose containing 1,000 million killed plague bacilli and the second dose containing 2,000 million killed plague bacilli; (4) in "10 double vaccination" packages of two 10 cc. vials, both doses to be used for ten immunizations, the first dose containing 1,000 million killed plague bacilli per cubic centimeter, and the second dose containing 2,000 million killed plague bacilli per cube centimeter, and (5) in "three dose" packages of three 1 cc. vials, the three doses to be used for immun- ization, the first dose containing 1,000 million, the second dose containing 2,000 million and the third dose containing 5,000 million killed plague bacilli, STAPHYLOCOCCUS VACCINE.— Vaccinum Staphy- lococcicum. — !Made from Staphylococcus aureus, from Staphy- lococcus albus, or from Staphylococcus citreus, or from all three. Actions and Uses. — Staphylococcus vaccine is used in car- bunculosis, furunculosis, sycosis, and certain cases of acne. An autogenous vaccine is preferable, but if this cannot be made, a stock vaccine can be used with some prospect of success. The forms of acne most likely to respond are characterized by deep- seated pustules, with considerable induration, occurring on the face, chest and back. When the lesions are superficial and indolent, the acne bacillus vaccine may give good results. Abbott Laboratories, North Chicago, 111. Furunculosis Bacterin-Abbott (Mixed). — Marketed in 6 and 20 cubic centimeter vials, each cvtbic centimeter containing 1,000 million killed organisms of Staphylococcus aureus and 1,000 million killed organisms of Staphylococcus albus. Cutter Laboratories, Berkeley, Calif. Staphylococcus Vaccine. — A suspension of strains of Staphylococcus aureus and albus in physiological solution of sodium chloride containing 0.5 per cent phenol, containing about 2,000 million to each cubic centi- meter. Marketed in 5 cc. vial packages. Dosage. — From 100 million to 1,000 million killed bacteria. The Gilliland Laboratories, Inc., Marietta, Pa. Staphylococcus Vaccine (Albus and Aureus). — A suspension oi Staphylococcus albus and Staphylococcus aureus in equal proportions, in physiological solution of sodium chloride and preserved with 0.25 per cent of trikresol. Marketed in packages of four vials containing, respec- tively, 250, 500, 1,000 and 2,000 million killed bacteria in 1 cc; in packages of one 5 cc. vial containing 2,000 million killed bacteria per cc_. and in bulk packages of 5 cc. and 10 cc. ampules, containing 2,000 million killed bacteria per cc. SERUMS AND VACCINES 411 Lederle Laboratories, Inc., Pearl River, N. Y. Staphylococcus Vaccine. — Marketed in packages of one 5 cc. vial con- taining 800 million killed Staphylococcus albus, 800 million killed Staphy- lococcus aureus and 400 million killed Staphylococcus citreus per cubic centimeter. Staphylococcus Aureus Vaccine, Polyvalent. — Marketed in packages of one 5 cc. vial containing 2,000 million killed Staphylococcus aureus per cubic centimeter. Eli Lilly & Co., Indianapolis. Staphylococcus Vaccine. — A suspension of strains of Staphylococcus aureus and Staphylococcus albus in physiological solution of sodium chloride, containing 2,000 million each of killed micro-organisms in each cubic centimeter. Merthiolate, 1:10,000, is used as a preservative. Marketed in single 5 cc. and 20 cc. vials. Staphylococcus Aureus Vaccine. — Marketed in single 5 cc. and 20 cc. vial packages, containing 2,000 million killed Staphylococcus aureus in each cubic centimeter of vaccine. Merthiolate, 1: 10,000, is used as a perservative. The National Drug Co., Philadelphia. Staphylococcus Vaccine. — A suspension of killed Staphylococcus albus and killed Staphylococcus aureus in equal proportions, in physiological solution of sodium chloride. Merthiolate, 1: 10,000, is used as a perserva- tive. Marketed in packages of one 5 cc. vial containing 2,000 million killed staphylococci per cubic centimeter; in packages of one 15 cc. vial containing 2,000 million killed staphylococci per cubic centimeter; in pack- ages of one 30 cc. vial containing 2,000 million killed staphylococci per cubic centimeter. Parke, Davis & Company, Detroit. Furunculosis Vaccine. — Marketed in packages of four 1 cc. bulbs, each containing 2,000 million killed Staphylococcus aureus obtained from furuncular lesions; also in 5 cc. and 20 cc. bulbs, each containing 2,000 million killed staphylococci per cubic centimeter. Staphylococcus Vaccine (Combined). — Marketed in packages of four 1 cc. bulbs, each containing 1,000 million killed Staphylococcus albus and 1,000 million killed Staphylococcus aureus; also in 5 cc. and 20 cc. bulbs, each containing 1,000 million killed Staphylococcus albus and 1,000 million killed Staphylococcus aureus per cubic centimeter. E. R. Squibb & Sons, New York. Staphylococcus Vaccine. — Marketed in vials of 5 cc. and 20 cc. each cubic centimeter containing 5,000 million killed Staphylococcus aureus and Staphylococcus albus in equal proportion. TYPHOID AND TYPHOID PARATYPHOID VACCINES Typhoid vaccine is made from Bacillus typhosus (Eberthella typhosa). In some cases Bacillus paratyphosus A (Salmonella paratyphi) and Bacillus paratyphosus B (S. shottmiilleri) are used either alone or combined with Bacillus typhosus, but usually the three organisms are combined in one vaccine. Actions and Uses. — Typhoid and paratyphoid vaccines are apparently useful in the prevention of typhoid and paratyphoid fever. The immunity produced is believed to persist in the majority of cases for two years or longer. The use of vaccine in the treatment of typhoid fever and of the carrier state has given inconclusive results and is not gen- erally considered of value. 412 NEW AND NONOFFICIAL REMEDIES BACTERIAL VACCINE MADE FROM THE TYPHOID BACILLUS.— Typhoid Prophylactic— Enteric Vaccine. — "A sterile suspension of killed typhoid bacilli (Eber- thella typhi) in physiological solution of sodium chloride or other suitable diluent. The vaccine shall contain, in each cc, at least 1,000,000,000 typhoid organisms." US.P. For standards see the U. S. Pharmacopeia under Vaccinum Typhosum. Actions and Uses. — See general article Typhoid and Para- typhoid Vaccines. Dosage. — "Average Dose — Prophylactic, by hypodermic injec- tion, 0.5 cc. and 1 cc, the latter dose to be repeated once." — U.S. P. As a preventive, typhoid vaccine should be admin- istered only to healthy persons. The skin should be sterilized with iodine and an initial dose of 500 million bacteria injected, with aseptic precautions. This injection should be followed in from seven to ten days by a second dose of one billion bac- teria and a third injection of the same size is given from seven to ten days after the second. The initial dose of combined typhoid vaccine contains 500 million Bacillus typhosus (Eber- thella typhosa) and 250 million of each of the paratyphoid organ- isms. The second and third doses should be twice the initial dose. Interval between doses should be the same as for typhoid vaccine. Tj^phoid vaccine is used in nonspecific protein therapy. The Cutter Laboratory, Berkeley, Calif. Typhoid Prophylactic. — A suspension made from a single strain, namely, that employed by the U. S. Army, containing 1,000 million killed typhoid bacilli per cubic centimeter. Marketed in packages of three bottles, one containing 500 million, and two each 1,000 million killed typhoid bacilli; also marketed in bottles of 20 cc. containing 1,000 million killed typhoid bacilli per cubic centimeter. The Gilliland Laboratories, Inc., Marietta. Pa. Typhoid Vaccine. — Prepared according to the method of the U. S. Army Medical School Laboratory from the Rawling's strain. Marketed in packages containing three syringes, the first containing 500 million killed typhoid bacilli and the second and third containing each 1,000 million killed typhoid bacilli; in packages containing three vials, the first containing 500 million killed typhoid bacilli, and the second and third containing each 1,000 million killed typhoid bacilli; also in vials containing 5, 10 and 20 cc. of the vaccine as ordered; also marketed in packages of thirty vials (ten complete immunizations), ten containing 500 million, and twenty containing 1,000 million killed typhoid bacilli each. Lederle Laboratories, Inc., Pearl River, N. Y. Typhoid Vaccine (Prophylactic). — Marketed in packages of one 5 cc. vial containing 1,000 million killed typhoid bacilli per cubic centimeter. Eli Lilly & Co., Indianapolis. Typhoid Vaccine, Prophylactic. — Marketed in immunization packages of three 1 cc. vials, one containing 500 million and two containing 1,000 million killed typhoid bacilli each, and in hospital size packages of ten complete immunizations in ten vials, one vial containing a complete immunization. Merthiolate, Lily, 1: 10,000 is used as a preservative. SERUMS AND VACCINES 413 Wm. S. Merrell Co., Cincinnati. Typhoid Vaccine. — A suspension of killed typhoid bacilli in physio- logic solution of sodium chloride, preserved with 0.5 per cent of phenol. The product is prepared according to the method of the U. S. Army Medical School from the Rawling's strain. Marketed in packages of three vials, the first containing 500 million killed typhoid bacilli in 0.5 cc. of suspension and the second and third containing 1,000 million killed typhoid bacilli in 1 cc. of suspension; in packages of one 5 cc. vial containing 1,000 million killed typhoid bacilli per cubic centimeter; and in packages of one 20 cc. vial containing 1,000 million killed typhoid bacilli per cubic centimeter. Alulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Typho-Bactcrin. — Marketed in packages ("immunizing") of three syringes and in packages of thirty 1 cc. vials (hospital size), being ten sets of three immunizing doses containing, respectively, 500, 1,000 and 1,000 million killed typhoid bacilli. The National Drug Co., Philadelphia. Typhoid Vaccine. — A suspension of killed Bacillus typhosus in physi- ological solution of sodium chloride. Merthiolate, 1: 10,000 is used as a preservative. Marketed in packages of one 5 cc. vial containing 1,500 million killed typhoid bacilli per cubic centimeter; in packages of one 15 cc. vial containing 1,500 million killed typhoid bacilli per cubic centi- meter; in packages of one 30 cc. vial containing 1,500 million killed typhoid bacilli per cubic centimeter; in three vial packages (one immuni- zation), the first dose containing 750 million killed typhoid bacilli and the second and third doses containing, respectively, 1,500 million killed typhoid bacilli. Parke, Davis & Company, Detroit. Typhoid Vaccine^ (Prophylactic). — Marketed in packages of three ampules, one containing 500 million, and two, 1,000 million, killed bacteria each; in packages of one 20 cc. vial containing 1,000 million killed typhoid bacilli per cubic centimeter; also in packages of ten 2J4 cc. rubber diaphragm capped vials, containing in each cc. 1,000 million killed typhoid bacilli. E. R. Squibb & Sons, New York. Typhoid Vaccine (Immunizing). — Marketed in packages of three ampules containing, respectively, 500, 1,000 and 1,000 million killed bacilli; also in hospital size packages of thirty ampules, ten containing 500 million and twenty containing 1,000 million killed bacilli; also marketed in packages of one 5 cc. vial containing 1,000 million killed typhoid bacilli per cubic centmeter; and in packages of one 20 cc. vial containing 1,000 million killed typhoid bacilli per cubic centimeter. United States Standard Products Company, Woodworth, Wis. Typhoid Vaccine. — Marketed in packages of three 1 cc. vials, containing 500 million, 1,000 million and 1,000 million killed typhoid bacteria, respectively, suspended in physiological solution of sodium chloride and preserved with 0.5 per cent phenol; also marketed in packages of one 5 cc. vial containing 1,000 million killed typhoid bacilli per cubic centi- meter and in packages of one 20 cc. vial containing 1,000 million killed typhoid bacilli per cubic centimeter. BACTERIAL VACCINE MADE FROM THE TYPHOID BACILLUS AND THE PARATYPHOID "A" AND "B" BACILLI.— Typhoid Combined Vaccine.— Typhoid-Paratyphoid Combined Vaccine, Typhoid Mixed Vac- cine Prophylactic. — Typhoid-Paratyphoid Prophylactic. — Mixed 414 NEW AND NONOFFICIAL REMEDIES Enteric Vaccine. — "A suspension in physiological solution of sodium chloride of killed typhoid bacillus (Eberthella typhi) and killed paratyphoid "A" bacilli (Salmonella paratyphi) and killed paratyphoid "B" bacilli (Salmonella schottmiilleri). "The vaccine shall contain In 1 cc, at least 1,000,000,000 typhoid organisms and at least 500,000,000 of each of the para- typhoid organisms." U.S.P. For standards see the U. S. Pharmacopeia under Vaccinum Typho-Paratyphosum. Actions and Uses. — See general article Typhoid and Typhoid- Paratyphoid Vaccines. Dosage. — "Average Dose — Prophylactic, by hypodermic injec- tion, 0.5 cc. and 1 cc, the latter dose to be repeated once." U.S.P. The Abbott Laboratories, North Chicago, 111. Typhoid-Paratyphoid Bacterin (Prophylactic). — Marketed in packages of three 1 cc. vials, one vial containing 500 million killed typhoid bacilli and 375 million each of paratyphoid bacilli A and B, while the other two vials each contain 1,000 million killed typhoid bacilli and 750 million each of paratyphoid bacilli A and B; in packages (hospital) of thirty-six ampoules, twelve of which contain 1,000 million killed typhoid bacilli and 750 million each of paratyphoid bacilli A and B, except those marked "Dose No. 1," which contain 500 million killed typhoid bacilli and 375 million each of paratyphoid bacilli A and B; and in 6 and 20 cc. vials, containing 1,000 million killed typhoid bacilli, and 750 million each nf paratyphoid bacilli A and B in each cubic centimeter. Cutter Laboratories, Berkeley, Calif. Typhoid-Paratyphoid Prophylactic. — Marketed in packages of three vials, one vial containing 500 million killed typhoid bacilli, 250 million killed paratyphoid A bacilli and 250 million killed paratyphoid B bacilli per cubic centimeter, and two vials each containing 1,000 million killed typhoid bacilli, 500 million killed paratyphoid A bacilli and 500 million killed paratyphoid B bacilli per cubic centimeter; in packages of one 20 cc. vial containing 1,000 million killed typhoid bacilli, 500 million killed para- typhoid A bacilli and 500 million killed paratyphoid B bacilli per cubic centimeter; and in packages of one syringe containing 1,000 million killed typhoid bacilli, 500 million killed paratyphoid A bacilli and 500 million killed paratyphoid B bacilli per cubic centimeter; also marketed in pack- ages of ten vials, ten complete treatments, each cubic centimeter contain- ing 1,000 million killed typhoid bacilli, 500 million killed paratyphoid A bacilli and 500 million killed paratyphoid B bacilli. The Gilliland Laboratories, Inc., Marietta, Pa. Typhoid-Paratyphoid Bacterial Vaccine Immunizing. — Marketed in packages of three 1 cc. vials one containing 250 million each killed paratyphoid A and B, and 500 million killed typhoid bacilli and two containing 500 million each killed paratyphoid A and B and 1,000 million killed typhoid bacilli, suspended in physiological solution of sodium chloride, containing 0.25 per cent of cresol; in packages of three 1 cc. syringes, one containing 250 million each of killed paratyphoid A and B and 500 million killed typhoid bacilli and two containing 500 million each of killed paratyphoid A and B and 1,000 million killed typhoid bacilli, suspended in physiological solution of sodium chloride containing 0.25 per cent of creosol; also marketed in vials containing 5, 10 and 20 cc. of the SERUMS AND VACCINES 415 latter strength; and in hospital size packages of ten complete immuniza- tions. Each immunizing treatment consists of three 1 cc. vials, the first dose containing 500 million killed typhoid bacilli, 250 million killed para- typhoid A bacilli and 250 million killed paratyphoid B bacilli and the second and third each containing 1,000 million killed typhoid bacilli, 500 million killed paratyphoid A bacilli and 500 million killed paratyphoid B bacilli. The Lederle Laboratories, Inc., Pearl River, N. Y. Typhoid Combined Vaccine (Prophylactic). — Marketed in packages of three vials containing, respectively, (1) 500 million killed typhoid bacilli, 250 million killed paratyphoid bacilli A and 250 million killed paratyphoid bacilli B, (2) 1,000 million killed typhoid bacilli, 500 miUion killed para- typhoid bacilli A and 500 million killed paratyphoid bacilli B, (3) 1,000 million killed typhoid bacilli, 500 million killed paratyphoid bacilli A and 500 million killed paratyphoid bacilli B; and in packages of one 5 cc. vial containing 1,000 million killed typhoid bacilli, 500 million killed parathyphoid bacilli A and 500 million killed paratyphoid bacilli B per cubic centimeter. Eli Lilly & Co., Indianapolis. Typhoid Mixed Vaccine, Prophylactic. — A suspension in physiological solution of sodium chloride, containing Merthiolate, Lilly, 1: 10,000 is used as a preservative. Marketed in packages of 5 and 20 cc. vials, each cubic centimeter containing 500 million each killed paratyphoid A and B, and 1,000 million killed typhoid bacilli; in packages of three 1 cc. vials, one, containing 250 million each killed paratyphoid A and B, and 500 million killed typhoid bacilli; two, the second and third doses, containing 500 million_ each killed paratyphoid A and B, and 1,000 million killed typhoid bacilli; also marketed in hospital size packages of ten complete immunizations in ten vials, each vial containing a complete immunization. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Typho-Bacterin Mixed (Triple Vaccine). — Marketed in packages of four 1 cc. syringes, the first dose containing 125 million killed typhoid bacteria, 62.5 million killed paratyphoid "A" bacteria and 62.5 million killed paratyphoid "B" bacteria; the second, third and fourth doses con- taining, respectively, two, four and eight times the number of bacteria in the first dose. Also marketed in 20 cc. vials, and in 5 cc. vials, con- taining 1,000 million killed typhoid bacteria, 500 million killed para- typhoid "A" bacteria and 500 million killed paratyphoid "B" bacteria per cubic centimeter. Typho-bacterin mixed is also supplied in packages of three syringes, in packages of three 1 cc. vials, the first dose containing 500 million killed typhoid bacteria, 250 million killed paratyphoid "A" bacteria and 250 million killed paratyphoid "B" bacteria, while the second and third doses contain, respectively, twice the number of bacteria in the first. Also marketed in packages of thirty 1 cc. vials, being ten immunizations of three doses each, the first dose containing 500 million killed typhoid bacilli and 250 million each of killed paratyphoid A and paratyphoid B bacilli, and the second and third doses each containing 1,000 million killed typhoid bacilli and 500 million each of killed para- typhoid A and paratyphoid B bacilli. Parke, Davis & Company, Detroit. Typhoid-Paratyphoid Vaccine (Prophylactic). — Marketed in packages of three 1 cc. bulbs, the first dose containing 500 million killed typhoid bacteria, 375 million killed paratyphoid A and 375 million killed para- typhoid B bacteria, the second and third doses each containing 1,000 million killed typhoid bacteria, 750 million killed paratyphoid A and 750 million killed paratyphoid B bacteria, respectively, suspended in physiological solution of sodium chloride and preserved with 0.3 per cent of cresol; in packages of one 20 cc. vial containing 1,000 million killed typhoid bacilli and 750 million each of killed paratyphoid bacilli A and B per cubic centimeter; also in packages of ten 2J^ cc. rubber diaphragm capped vials, containing in each cc. 1,C00 million killed typhoid bacilli, 750 million killed paratyphoid A and 750 million killed paratyphoid B bacilli. 416 NEW AND NONOFFICIAL REMEDIES E. R. Squibb & Sons, New York. Typhoid Vaccine Combined, Immunising — Marketed in packages of three vials, one containing 500 million killed typhoid bacilli and 375 million each of killed paratyphoid A and paratyphoid B bacilli, and each of the other two vials containing 1,000 million killed typhoid bacilli and 750 million each of killed paratyphoid A and paratyphoid B bacilli; in packages of thirty ampules, hospital size, ten of which contain, each, 500 million killed typhoid bacilli and 375 million each of killed paratyphoid A and paratyphoid B bacilli, and twenty of which contain, each, 1,000 million killed typhoid bacilli, and 750 million each of killed paratyphoid A and paratyphoid B bacilli; and in vials of 5 cc, and 20 cc, each cubic centimeter containing 2,500 million killed bacilli. United States Standard Products Company, Woodworth, Wis. Typhoid ParatypJioid Vaccine Combined.- — Marketed in packages of three 1 cc. vials, the first dose containing 500 million killed typhoid bac- teria, 375 million killed paratyphoid A and 375 million killed paratyphoid B bacteria, the second and third doses each containing 1,000 million killed typhoid bacteria, 750 million killed paratyphoid A bacteria and 750 million killed paratyphoid B, suspended in physiological solution of sodium chloride and preserved with 0.5 per cent phenol; also marketed in pack- ages of one 5 cc. vial, each vial containing 1,000 million killed typhoid bacilli, 750 million killed paratyphoid A bacilli, and 750 million killed paratyphoid B bacilli per cubic centimeter, and in packages of one 20 cc. vial containing, respectively, 1,000 million killed typhoid bacilli, 750 million killed paratyphoid A bacilli, and 750 million killed paratyphoid B bacilli per cubic centimeter. Mixed Bacterial Vaccines These contain more than one species of bacteria. Actions and Uses. — The employment of bacterial vaccines should be based either on the discovery of the causative micro- organism by careful bacteriologic examination of the patient under treatment or on well established clinical knowledge which has shown the disease present to be regularly due to the activity of a definite germ. As a rule, one organism plays the predomi- nant role and the destruction of the causative agent will effect a cure. In some cases, however, it has been found that two or more organisms are associated in producing the diseased con- dition. In such cases, a vaccine containing all the known causa- tive antigens has been thought to be indicated. When this etiologic association has been determined by actual bacteriologic examination, a mixture of two autogenous vaccines or two corresponding stock vaccines may have a logical basis. If the bacteriologic examination is omitted, the mixture rests on a purely hypothetical assumption and the method becomes wholly irrational. While the subject was still in the earlier experimental stage, various mixtures of vaccine, so-called "mixed" vaccines, were admitted to N. N. R. by the Council. As knowledge concern- ing the action of these products increased, however, it was found inadvisable, in most instances, to continue recognition of them ; and the mixed vaccines, which had been admitted, were deleted unless their usefulness was established by acceptable clinical evidence. New mixed vaccine products are subject to the same conditions before being accepted. SERUMS AND VACCINES 417 ERYSIPELAS AND PRODIGIOSUS TOXINS (COLEY). — Toxicum Erysipelatis et Toxicum Bacilli Prodigiosi. — This preparation is practically a mixed bacterial vaccine made from strains of hemolytic streptococci isolated from cases of erysipelas and from Bacillus prodigiosus (Serratia marcescens). Its use has been advised in cases of inoperable sarcoma. Actions and Uses. — This remedy is said to have benefited and produced cures in a small percentage of patients treated, though there is some difference of opinion as to this. Dosage. — For adults from 0.02 to 0.8 cc. (0.25 to 10 minims). Dose for a child should be proportionately smaller according to weight of patient. It is given by hypodermic injection. The first few doses should be systemic, at some distance from the tumor. When injections are made into the tumor only one quarter to one half the dose for injection outside the tumor is required to produce the same reaction. A reaction, some- times severe, consisting of chill and rise of temperature is expected to follow the injections, until tolerance becomes e'^tablished. Parke, Davis & Company, Detroit. Erysipelas and Prodigiosus Toxins (Coley). — Marketed in packages c ritaining five 1 cc. bulbs and in 15 cc. bulbs. Sensitized Bacterial Vaccines — Serohacterins These products are prepared in the same manner as bac- terial vaccines, except that the bacterial suspensions are treated with the serum of an animal which has been immun- ized to some extent against the species of organism in hand. The serum is then washed from the bacterial bodies by cen- trifugation and the latter are resuspended in physiological solution of sodium chloride. Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Acne Serobacterin-Mulford (Sensitized Acne Vaccine Polyvalent). — Marketed in packages of four 1 cc. syringes, containing, respectively, 100 million, 200 million, 400 million and 800 million killed sensitized bacteria {B. acne); in 5 cc. vials, containing 800 million killed sensitized bacteria per cubic centimeter. Cholera Serobacterin-Mulford (Sensitized Cholera Vaccine). — Marketed in packages of three syringes, containing, respectively, 500, 1.000 and 2,000 million killed sensitized cholera vibriones suspended in sterile physiological solution of sedium chloride. Staphylo-Serobacterin (Sensitized Staphylococcic Vaccine). — Marketed in packages of four syringes, containing, respectively. Staphylococcus aureus and Staphylococcus albus in equal proportions, 500, 1,000, 2,000 and 4,000 million killed sensitized staphylococci; in 5 cc. vials, contain- ing 4,000 million killed sensitized staphylococci per cubic centimeter. Typho-Serobacterin-Mulford (Sensitized Typhoid Vaccine). — Marketed in packages of 5 cc. vials, each containing 2,000 million killed sensitized typhoid bacilli per cubic centimeter. Also marketed in packages of three syringes, being three immunizing doses, the first containing 1,000 million and the second and third each containing 2,000 million killed typhoid bacilli. 418 NEW AND NONOFFICIAL REMEDIES Typho-Serobacterin-Mulford Mixed (Sensitized Triple Vaccine). — Marketed in packages of four 1 cc. syringes, the first dose containing 250 million killed sensitized typhoid bacteria, 125 million killed sensitized paratyphoid_ "A" bacteria and 125 million killed sensitized paratyphoid "B" bacteria; the second, third and fourth doses contain, respectively, two, four and eight times the number of bacteria in the first dose. Also marketed in 5 cc. vials, and in single 1 cc. syringes containing 2,000 million killed sensitized typhoid bacteria, 1,000 million killed sensitized paratyphoid "A" bacteria, and 1,000 million killed sensitized paratyphoid "B" bacteria per cubic centimeter; in packages of three syringes and in packages of three 1 cc. vials, the first dose containing 1,000 million killed sensitized typhoid bacteria, 500 million killed sensitized paratyphoid "A" bacteria and 500 million killed paratyphoid "B" bacteria, while the second and third doses contain, respectively, twice the number of bacteria in the first dose; in packages of thirty 1 cc. vials (hospital size), being ten sets of three doses, the first containing 1,000 million killed sensitized typhoid bacilli, and 500 million each of killed sensitized paratyphoid bacilli A and B, the second and third containing, respectively, twice the number of bacilli in the first dose. IV. Diagnostic Agents TOXINS FOR IMMUNITY TESTS DIPHTHERIA TOXIN FOR THE SCHICK TEST. — Schick Test Toxin. — "A solution of the toxic products of growth of the diphtheria bacillus (Corynebacterinm diph- theriae)." US.P. For standards see the U. S. Pharmacopeia under Toxinum Diphthericum Diagnosticum. Actions and Uses. — This test is intended to determine those persons who are immune to diphtheria. In nonimmune per- sons a circumscribed area of redness and infiltration from 1 to 2 cm. in diameter develops at the site following injection of 0.1 or 0.2 cc. of the Schick test material. The reaction occurs in from twenty-four to forty-eight hours, and is at its height in from forty-eight to seventy-two hours. It remains for from six to twelve days, is followed by slight scaling, and leaves a brownish, pigmented spot. In some persons, a pseudoreaction may occur, which may be differentiated by its earlier appearance and disappearance, and the facts that it is less circumscribed and is not followed by pigmentation. Diphtheria toxin diluted for use with physiologic solution of sodium chloride soon loses in potency. Dilution of the material should be made only on the day of test. Diphtheria toxin diluted with peptone solution is apparently quite stable. Cutter Laboratory, Berkeley, Calif. Diphtheria Toxin for the Schick Test. — Marketed in packages of two vials, one containing a definite volume of diphtheria toxin and the other containing sterile physiologic solution of sodium chloride with which the toxin is to be diluted before administration. The diluted toxin is of such a strength that 0.1 cc. given intracutaneously constitutes a one-fiftieth M.L.D. There are approximately 50 test doses in each package. Also marketed in packages containing sufficient material for ten tests. Diphtheria Toxin for the Schick Test, Diluted Ready for Use. — An aged standardized diphtheria toxin is diluted with peptone solution accord- ing to the method of White, Bunney and Malcolm so that 0.1 cc. contains SERUMS AND VACCINES 419 a standard Schick test dose. Samples of each lot are tested for sterility by the method of the National Institute of Health. The product is ready for use, no diluent being required. Marketed in packages containing sufficient diluted diphtheria toxin for ten and fifty tests. The GilHland Laboratories, Inc., Marietta, Pa. Diphtheria Schick Test Toxin, Diluted Ready for Administration- Gilliland. — A diphtheria toxin made by growing diphtheria bacilli in broth, aging and diluting with peptone solution according to VV. E. Bunney (/. Immunol. 20:71, 1931). The product is ready for use, no diluent being required. The diluted toxin is of such strength that 0.1 cc. (one dose) given intradermally. constitutes one-fiftieth minimum lethal dose for a guinea-pig of 250 Gm. weight. Marketed in packages con- taining sufficient material for 10, 25 and SO tests. Hixson Laboratories, Inc., Johnstown, Ohio. Diphtheria Toxin for the Schick Test (Diluted). — A diphtheria toxin prepared by growing diphtheria bacilli in broth, aging and diluting with a solution containing sodium borate 0.36 per cent, boric acid 0.53 per cent, and sodium chloride 0.61 per cent. The diluted toxin is of such strength that 0.1 cc. (one dose) given intracutaneously constitutes one-fiftieth minimum lethal dose for a guinea-pig of 250 Gm. weight. The product as marketed is ready for use, no diluent being required. Merthiolate 1: 10,000 is used as preservative. Marketed in packages containing suffi- cient material for 10, 25 and 50 tests. Lederle Laboratories, Inc., Pearl River, N. Y. Diphtheria Toxin for Schick Test in Peptone Solution. — A diphtheria toxin made by growing diphtheria bacilli in broth, aging, and diluting with peptone solution according to White, Bunney and Malcolm (/. Immunol. 33: 93, 1932), The product is ready for use, no diluent being required. The diluted toxin is of such strength that 0.1 cc. (one dose) given intracutaneously constitutes one-fiftieth minimum lethal dose for a guinea-pig of 250 Gm. weight. Marketed in packages of one syringe containing diluted diphtheria toxin sufficient for one test, in packages of one vial containing diluted diphtheria toxin sufficient for ten tests, and in packages of one vial containing diluted diphtheria toxin sufficient for fifty tests. As a means of co'ntrol, diphtheria toxin heated to 75 C. for ten minutes and diluted with peptone solution is supplied in packages of one syringe containing sufficient material for one control test and in packages of one vial containing sufficient material for ten control tests. Schick Test. — Marketed in packages of one vial containing undiluted diohtheria toxin sufficient for 50 tests; in packages of one vial containing undiluted diphtheria toxin sufficient for 100 tests. Each package is accom- panied by the required amount of sterile diluent. Eli Lilly & Company, Indianapolis. Diphtheria Toxin for Schick Test, Diluted Ready for Use-Lilly.— A diphtheria toxin diluted with physiological solution of sodium chloride containing 0.1 _ per cent gelatin and having a pu of 7.8 to 8.0. The diluted toxin is of such strength that 0.1 cc. (one dose) given intra- cutaneously constitutes one-fiftieth minimal lethal dose for a guinea-pig of 250 Gni. weight. It is marketed in packages of one vial containing sufficient diluted diphtheria toxin for ten tests, and in one vial containing sufficient diluted diphtheria toxin for 100 tests. Wm. S. Merrell Co., Cincinnati. Diphtheria Toxin for the Schick Test, Diluted with Peptone Solution and Ready for Use. — A diphtheria toxin made by growing diphtheria bacilli in broth, aging and diluting with peptone solution according to Bunney (/. Immunol. 30:71 [Jan.] 1931). The product is ready for use, no diluent being required. The diluted toxin is of such strength that 0.1 cc. (one dose) given intradermally constitutes one-fifieth mini- mal lethal dose for a guinea-pig of 250 Gm. weight. Marketed in pack- ages containing sufficient material for 10 and 100 tests. 420 NEW AND NONOFFICIAL REMEDIES Mulford Biological Laboratories, Sharp & Dohme, Phila- delphia and Baltimore. Diphtheria Toxin for Schick Test, Diluted Ready for Use-Mulford. — A diphtheria toxin diluted with a sodium chloride-borax-boric acid bufiEer solu- tion containing 0.1 per cent of Witte's peptone, so that 0.1 cc. contains a Schick test dose (V^o minimum lethal dose). The minimum lethal dose is determined by injection of graduated doses into a series of 250 Gm. guinea-pigs. Marketed in 1 cc. vials containing sufficient material for ten tests; in 5 cc. vials containing sufficient material for fifty tests and in 10 cc. vials containing sufficient material for one hundred tests. For the control test a diluted diphtheria toxin inactivated by heat is supplied in 5 cc. vials representing sufficient material for fifty control tests. The National Drug Co., Philadelphia. Schick Test, Peptone Diluent. — A diphtheria toxin made by growing diphtheria bacilli in broth, aging and diluting with peptone solution according to W. E. Bunney (/. Innnunol. 33:93, 1932). The product is ready to use, no diluent being required. Marketed in packages of one 1 cc. vial containing sufficient diluted diphtheria toxin for ten tests; in packages of one 5 cc. vial containing sufficient diluted diphtheria toxin for fifty tests, and in packages of one 10 cc. vial containing suffi- cient diluted diphtheria toxin for one hundred tests. For the control test, the product is supplied in single vial packages of 1 cc. and 5 cc, containing, respectively, sufficient heated diphtheria toxin diluted with peptone solution, for ten and fifty control tests. Parke, Davis & Co., Detroit. Diphtheria Toxin Diluted for Schick Tr^f.-— Marketed in packages of one vial containing 1 cc. of diluted diphtheria toxin, sufficient _ tor ten tests; and in packages of one vial containing 10 cc. of diluted diphtheria toxin, sufficient for 100 tests. The dose is 0.1 cc. of the diluted toxin or one-fiftieth of the minimum lethal dose of diphtheria toxin for a guinea- pig of 250 Gm. weight. As a means of control, the control for the Schick test, representing diluted diphtheria toxin heated sufficient to destroy the specific exotoxins, is supplied. E. R. Squibb & Sons, New York. Diphtheria Toxin for the Schick Test, Ready to Use tuithoiit Dilution- Squibb. — A diphtheria toxin made by growing diphtheria bacilli in broth, aging, and diluting with peptone solution according to W. E. Bunney (J. Immunol. 30:71, 1931). The product is ready for use, no diluent being required. The diluted toxin is of such strength that 0.1 cc. (one dose) given intracutaneously constitutes one-fiftieth minimum lethal dose for a guinea-pig of 250 Gm. weight. It is marketed in packages of \ cc. containing sufficient for ten tests and in packages of 10 cc. containing sufficient for 100 tests. United States Standard Products Company, Woodworth, Wis. Diphtheria Toxin for Schick Test and Control. — Marketed in packages containing a vial with undiluted diphtheria toxin standardized, and a 2 cc. vial of sterilized physiological solution of sodium chloride with which the toxin is diluted before using. The dose is 0.2 cc. : each pack- age contains, therefore, 10 tests. As a means of control, there is also supplied diphtheria toxin of the same lot but heated sufficiently to destroy the specific exotoxins and 2 cc. of physiological solution of sodium chloride for diluent. The product is marketed in packages containing 5 times the foregoing amount, sufficient for 50 tests and control tests; also marketed in packages sufficient for 100 tests, but the strength of the toxin is such that the dose is 0.1 cc. SCARLET FEVER STREPTOCOCCIC TOXIN, U.S. P. — (for definition see this title under Bacterial Toxin.) Actions and Uses. — The toxin of the hemolytic streptococcus of scarlet fever is used to determine those persons who are susceptible to scarlet fever. The toxin is first carefully standard- SERUMS AND VACCINES 421 ized on human beings and diluted so that 0.1 cc. represents a skin test dose. The test dose is injected intracutaneously on the forearm and the degree of susceptibility is determined at the end of from twenty-two to twenty-four hours. An area of reddening 1 cm. or more in diameter constitutes some degree of a posi- tive reaction, while a smaller area of reddening is considered negative. Reactions which have appeared but which have entirely faded at the end of twenty-four hours are regarded as negative. Positive reactions fade rapidly and have usually disappeared at the end of from forty-eight to seventy-two hours. Scarlet fever streptococcus toxin diluted for use will retain its potency for at least two months at room temperature. Lederle Laboratories, Inc., Pearl River, N. Y. Scarlet Fever Streptococcus Toxin for the Dick Test. — Prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. Marketed in packages of one vial containing sufficient toxin for ten tests ; in pack- ages of one vial containing sufficient toxin for 100 tests. Mulford Biological Laboratories. Sharp ^- Dolmie. Phila- delphia and Baltimore. Scarlet Fever Streptococcus Toxin for the Dick Tcst-Mtilford. Pre- pared by the method of Drs. Dick under U. S. Patent 1,547,369 (July 29, 1925; expires 1942) by license of the Scarlet Fever Committee Incorporated. Marketed in 1-cc. ampoules containing diluted toxin ready for immediate use sufficient for ten tests (in 0.1 cc. doses); also in packages of one 10-cc. ampoule-vial containing diluted toxin ready for immediate use, sufficient for 100 tests. The National Drug Co., Philadelphia. Scarlet Fever Streptococcus Toxin for the Dick Test "National." — Prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. Marketed in packages of one vial containing sufficient toxin for ten tests; in packages of one vial containing sufficient toxin for one hundred tests; also in packages of one vial containing sufficient toxin for fifty tests. Parke, Davis & Co., Detroit. Scarlet Fever Streptococcus Toxin for Dick Test-P. D. & Co. — Pre- pared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. Marketed in single 1 cc. vial packages containing sufficient toxin for ten tests; and in packages of one 10 cc. vial containing sufficient toxin for one hundred tests. E. R. Squibb & Sons, New York. Scarlet Fever Streptococcus Toxin for Dick Test-Squibh. — Prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. Marketed in packages of one vial containing sufficient toxin for ten tests; in packages of one vial containing sufficient toxin for 100 tests. United States Standard Products Company, Woodworth, Wis. Scarlet Fever Streptococcus Toxin for the Dick Test. — Prepared by the method of Drs. Dick under U. S. patent 1,547,369 (July 28, 1925; expires 1942) by license of the Scarlet Fever Committee, Inc. Marketed in packages of one ampule containing sufficient toxin for ten tests, and in packages of one vial containing sufficient toxin for 100 tests. 422 NEW AND NONOFFICIAL REMEDIES SILVER PREPARATIONS Silver compounds are used in medicine to secure caustic, astringent, germicidal and antiseptic effects. These results are produced by the free silver ions. When caustic effects are desired, silver nitrate is preferred, because the colloidal com- pounds of silver are largely or completely lacking in caustic properties. As an astringent, also, silver nitrate is the compound of choice ; but it must be used in weaker solutions. The anti- septic action of silver nitrate is complicated by irritation, pain, astringency and corrosion. These may be desirable for the destruction of tissue or the stimulation of indolent wounds ; but when they are not necessary for such purposes, they may be avoided by the use of colloidal silver preparations. Caution: The long continued use of any silver preparation may produce irremediable discoloration of the skin or mucous membrane (argyria). Colloidal Silver Preparations In these, the silver does not exist to any great extent as free ions ; therefore, it does not precipitate chlorides or pro- teins, and is noncorrosive and relatively or quite nonastringent and nonirritant, but some degree of antiseptic action is retained. This is not proportional to the total silver content, and varies for the different compounds ; suggesting that the antiseptic action is due to the liberation of very low concentrations of silver ions, which vary for the different compounds. The mechanism of these effects is analogous to the late action of silver nitrate. This takes place in two stages: (1) the immediate irritant and germicidal effects produced by the direct application of the free silver ions; and (2) the later, milder antiseptic effects produced by the re-solution of the protein silver compounds that were formed in the first stage. If the second stage alone is desired (i. e., mild antiseptics without irritation), the direct application of the colloid com- pounds may have advantages over their indirect production from silver nitrate, aside from the avoidance of irritation ; for the absence of any coagulation membrane facilitates their access to the cells ; they form more concentrated solutions than are likely to be formed from the re-solution of the silver precipitates in situ; the colloidal aggregates may be smaller and therefore more reactive; and because of the absence of irritation, they are likely to be more frequently applied and would for that reason secure a more continuous action. The colloidal silver preparations appear to be quite efficacious for the prophylaxis against gonorrheal infection, evidently killing these organisms on direct contact. Culver (J. Lab. & Clin. Med. 3:487 [May] 1918) reports that gonococci in hydro- cele broth cultures are killed by momentary exposure to 0.5 SILVER PREPARATIONS 423 per cent mild protein silver or to 0.25 per cent strong protein silver. As regards other organisms, discordant results have been reported. Metallic silver and insoluble compounds of silver, such as the oxide, the halogen salts (iodide, chloride, etc.) and protein- silver precipitates, may be brought into "colloidal solution" ; i. e., if they are sufficiently finely divided, they become miscible with water, so that they apparently go into solution (such "colloidal solutions" are strictly permanent "suspensions" of the insoluble substance in a state of ultrarnicroscopic particles). The commercial preparations are for the most part produced by dissolving reduced silver or silver oxide, or some protein- silver precipitate, in an excess of a denatured protein, and drying in vacuo. This results in substances that dissolve very freely, although somewhat slowly, in water yielding brown "colloid solutions" which contain so little of free silver ions that they do not readily precipitate chlorides or proteins. They consist of indefinite mixtures of metallic silver, silver oxide, and various silver-protein compounds, all in colloidal form. The proportions of these and the properties of the mixture vary according to the conditions under which they are produced. Although there are many gradations, most of the products on the market fall into a small number of fairly definite thera- peutic groups : (A) Protein Silver, Strong Type. (B) Protein Silver, Mild Type. (C) Collargol Type. (D) Electric Type. A. Protein Silver, Strong Type. — Strong protein silver com- pounds contain the lowest percentage of silver (from 7.5 to 8.5 per cent), but have the strongest germicidal action, and are distinctly irritant. They are, therefore, therapeutically intermediate between silver nitrate and mild protein silver. Protargol belongs to this group. Protargol is said to be prepared by precipitating a "peptone" (albumose) solution with silver nitrate, or with moist silver oxide; dissolving the silver peptonate in an excess of protal- bumose; and drying in vacuo (Fraenkel). B. Protein Silver, Mild Type. — Mild protein silver compounds contain from 19 to 25 per cent of silver, but are quite non- irritant. The following products listed in N. N. R. belong to this group: argyn; cargentos ; silvol; solargentum- Squibb. Argyn is defined as a colloidal compound of silver oxide and serum albumin. Solargentum- Squibb is prepared from alkali-gelatin, used as a solvent for silver oxide. The solution is then concentrated and dried in vacno. Cargentos is prepared by suspending moist silver oxide in a solution of casein, and heating the mixture until no pre- 424 NEW AND NONOFFICIAL REMEDIES cipitate is obtained on the addition of solution of sodium chloride, and by evaporating the mixture to dryness in an air oven. C. Collargol Type. This contains a much higher percentage (78) of silver, said to be in the form of metallic silver, reduced to the colloidal form by chemical means, and "stabilized'' by "a small percentage of egg albumin with products of oxidation." However, the albumin is denatured, since it does not precipitate on boiling; and it presumably constitutes the greater part of the 22 per cent that is not silver. Collargol, therefore, differs from the preceding class in degree rather than in principle, containing a larger proportion of silver in the form of colloidal- metal and oxide, and a smaller proportion in the form of proteinate. Its therapeutic field has been mainly for intravenous and intramuscular injection. According to the results of Bottner (Miinchen. med. Wchnschr. 68:876 [July 15] 1921) the thera- peutic response would appear to be due to the foreign proteins, rather than to the silver. D, Electric Type. — Metallic silver may be brought into colloidal solution electrically, i. e., by forming an arc between silver electrodes under water. These solutions are very dilute and are not sufficiently stable for concentration. They are also likely to contain silver oxide, and sometimes ionized silver. Therapeutic Uses. — The colloidal silver compounds are used mainly on mucous membranes, for antisepsis. The protein silver, strong group is most effective in this respect, but is slightly irritant and stimulant. The protein silver, mild group acts largely as mucilaginous demulcent and protective ; and as detergent, by dislodging pus. Collargol acts locally like the protein silver, mild group, but is used mainly to produce sys- temic reactions. The antiseptic efficiency of the silver compounds and their content of silver ions may be conveniently compared by their restraining effect on gas-formation by yeast, according to the method of Dreser, as modified by Pilcher and Sollmann (J. Lab. & Clin. Med. 8:301, 1923. According to this, the following solutions approximately equal the efficiency of a 1 in 1,000 solution of silver nitrate in the same media (J. Lab. & Clin. Med. 9:260, 1924): protargol in water 1 per cent, in physiological solution of sodium chloride 0.125 per cent, in blood 0.9 per cent; and silvol in water 36 per cent, in physiological solution of sodium chloride 1 per cent, in blood 3 per cent. The protein silvers have been administered by mouth as gastro-intestinal antiseptics. It appears most improbable that the low concentration that could be secured in this manner would have any antibacterial action ; there is no decisive clinical evidence of such an effect. Dosage and Administration. — The concentrations for mucous membranes range from 0.1 to 10 per cent for strong protein silver ; from 5 to 50 per cent for mild protein silver, and SILVER PREPARATIONS 425 from 0.02 to 1 per cent for collargol. These are applied every two to four hours, if possible. Solutions should be recently prepared, and should be protected against light. Ointments and suppositories are used with the same concentrations as the aqueous solutions. Stains on linen are removed by 1 in 1,000 solution of mercuric chloride. The usual concentrations for special purposes are shown in the adjoined table. Strong Protein Silver Mild Protein Silver Eye : Per Cent Per Cent Conjunctivitis, simple pu- rulent or gonorrheal... 2 to 10 Solution, 25 Ointment, 10 Prophylaxis against oph- thalmia neonatorum 2 to 10 25 Prophylaxis before ophthal- mic operations (several days) 25 Corneal ulcers 50 Nose and throat 0.5 to 10 Spray, 10 to 20 Swab, 25 to 50 Wounds and ulcers 1 to 10, solution or ointment 10, dusting pow^der Gonorrhea : Injections — Prophylactic . . 2 10 Acute ^ to 1 3 to 10 Chronic 2 to 10 10 to 20 Urethral irrigation 1 : 2,000 to 1 : 1,000 1:1,000 Urethral suppositories 5 to 10 20 (0.13 Cm. or 2 erains) Cystitis 20 to 50 (5 cc.) or 10 to 25 (30 cc.) left in the bladder Cynecologic practice: Solutions 2 to 10 25 (tarnpons of solu- tion in glycerin) Tampons 2 Ointments 5 Suppositories 5 Suppositories, 20 (0.3 Gm. or 5 grains) Rectal administration : Irrigation 0.1 0.1 to 1 Injection 2 10 Suppositories 5 to 10 20 (0.13 Gm. or 2 grains) Oral administration 0.002 to 0.015 Gm. 0.3 Gm. (5 grains) iVs2 to li grain) Pyelography 2 (solargentum) 50 (cargentos) (Early Preventive) Treatment of Venereal Diseases. — The ordinary routine consists in washing the parts thoroughly with soap and water, after which a 2 per cent strong protein silver solution is injected into the urethra and held there for five minutes. The glans is then inuncted with 30 per cent mild mercurous chloride ointment for five minutes. The efficacy is marked if the treatment is applied thoroughly within an hour after exposure, and is fair up to three hours. In the A. E. F., the ratio of diseases to exposure was about 426 NEW AND NONOFFICIAL REMEDIES 1 in 30 without prophylactic treatment, and 1 in 90 with treatment. Prophylaxis, therefore, reduced the incidence to about one third (Ashburn, 1919). It is practically useless after five hours. STRONG PROTEIN SILVER. — Argento-Proteinum Forte U. S. P. X. — Strong Silver Protein. — Strong Protargin. — "A compound of silver and protein, containing not less than 7.5 per cent and not more than 8.5 per cent of silver (Ag). "Caution. — Solutions of Strong Protein Silver should be freshly prepared and should be dispensed in amber-colored bottles." U. S. P. For standards see the U. S. Pharmacopeia under Argentum Proteinicum Forte. Actions, Uses and Dosage. — See preceding article, Silver Preparations. Solutions are best prepared by dusting the powder on the surface of cold water, and allowing it to dissolve without stirring or shaking. This requires about ten minutes. Solutions should be freshly prepared. Protargol. — A brand of strong protein silver-U. S. P. Pro- targol is a compound of silver-albumose. Manufactured by Winthrop Chemical Company, Inc., New York. U. S. patent expired. U. S. trademark 30,882. Granules Protargol Compound. — Protargol, 22^3 per cent, and urea, 66^ per cent. The urea is added because of its effect of increasing the solubility but is otherwise inert. MILD PROTEIN SILVER.— Argento-Proteinum Mite U. S. P. X.— Mild Silver Protein.— Mild Protargin.— "Silver rendered colloidal by the presence of or combining with protein. It contains not less than 19 per cent and not more than 25 per cent of silver (Ag). "Caution. — Solutions of Mild Protein Silver should be freshly prepared and should be dispensed in amber-colored bottles." U. S. P. For standards see the U. S. Pharmacopeia under Argentum Proteinicum Mite. Actions, Uses and Dosage. — See preceding article, Silver Preparations. Argyn. — A brand of mild protein silver-U. S. P.^ Argyn is a colloidal compound of silver oxide and serum albumin. Manufactured by the Abbott Laboratories, North Chicago, 111. No U. S. patent. U. S. trademark 137,522. Argyn Tablets, 6 grains. Cargentos. — Argenti Oxidum Colloidale-Mulford.— A brand of mild protein silver-U. S. P. Cargentos is a colloidal preparation of silver oxide and modified casein. Manufactured by Sharp & Dohme, Philadelphia and Baltimore. U. S. patent 1,043,646 (Nov. 5, 1912; expired). No U. S. trademark. SILVER PREPARATIONS 427 Cargentos Capsules, 3 Grains. — Capsules of Colloidal Silver Oxicle- Rlulford 3 grains. Cargentos Ointment, 5 Per Cent. — Ointment of Colloidal Silver Oxide- Mulford, 5 per cent: Cargentos, 1 part; anhydrous wool fat, 19 parts; put up in collapsible tubes. Cargentos Ointment, 10 Per Cent. — Ointment of Colloidal Silver Oxide- Mulford, 10 per cent: Cargentos, 1 part; anhydrous wool fat, 9 parts, put up in collapsible tubes. Cargentos Urethral Suppositories. — Colloidal Silver Oxide Urethral Sup- positories or Bougies-Mulford: Each suppository weighs about 2.5 Gm. {2>7 grains). The vehicle consists of glycerite of boroglycerin, gelatin and water. Silvol. — A brand of mild protein silver-U. S. P. Silvol is a compound of colloidal silver with an alkaline proteid. Manufactured by Parke, Davis & Co., Detroit. No U. S. patent or trademark. Capsules Silvol, 6 grains. Silvol Bougies 5 Per Cent: Bougies weighing 0.81 Gm. (12.5 grains) and containing silvol 5 per cent in a base composed of oil of theobroma, wool fat, white wax, acacia and glucose. Silvol Ointment 5 Per Cent: Silvol, 5 per cent in a base composed of petrolatum, wool fat, benzoinated lard and white wax. Vaginal Suppositories Silvol 5 Per Cent: Suppositories weighing 8.45 Gm. (130 grains) and containing silvol, 5 per cent, in a base composed of gelatin and glycerin. Solargentum. — A brand of mild protein silyer-U. S. P. Solargentum is a compound of silver and gelatin, containing from 19 to 23 per cent of silver in colloidal form. Manufactured by E. R. Squibb & Sons, New York. No' U. S. patent. U. S. trademark 328,686. Tablets Solargentum, 4.6 grains. COLLARGOL. — Collargolum. — Colloidal Silver.— Argentum Colloidale. — Argentum Crede. — Colloidal silver and silver oxide, formed by reduction and stabilized by derived egg- albumin, with which it is possibly partly combined, Collargol contains silver equivalent to approximately 78 per cent metallic silver, of which about 2 per cent is ionized. It fornns a fairly stable colloidal suspension in water. Actions and Uses. — The intravenous injection of collargol is followed, after from two to four hours, by a chill, fever and leukocytosis. This reaction has been used, with variable results, against general and localized infections, similar to nonspecific protein therapy. Indeed, it is possible that the protein stabilizer may play the principal or sole part in the reaction. The direct antiseptic action is feeble, and probably due to contamination with free silver ions. Dosage. — It is employed in carefully filtered solutions (colloidal suspensions) varying in strength according to the intended use ; from 10 to 20 cc. of a 2 per cent solution for intravenous injections (the possible reaction of certain persons to tgg protein should be considered) ; and from 0.02 to 1 per cent solution for washes. Collargol solution should not be 428 NEW AND NONOFFICIAL REMEDIES sterilized by boiling, but sterile solution mediums should be used. Locally, it is used in the form of a 15 per cent ointment (see collargol ointment), from 2 to 4 Gm. (30 to 60 grains) being very thoroughly rubbed into the skin ; in the form of 5 per cent dusting powder, prepared with finest clay ; in bougies containing 0.2 (^m. (3 grains), in vaginal suppositories and tampons each containing 0.05 Gm. (^ grain), and for parenteral injections in from 0.5 to 1 per cent glycerin solutions. Manufactured by the Heyden Chemical Company of America, Inc.. Garfield, N. J. (Schering and Glatz, Inc., New York, distributor). U. S. trademark 32,452. Collargol occurs as small, hard, brittle, bluish-black scale-like pieces. With 20 parts of distilled water, it forms a colloidal suspension, black in incident light and reddish brown in transmitted light, which remains stable for months. The addition of albumin to collargol prevents or delay s_ its precipitation by acids and salts. _ A sufficient amount of albumin to prevent its precipitation under ordinary conditions is, there- fore, added to collargol during its manufacture. Hence, collargol. when added to spring or well-water containing salts, undergoes no change, whereas colloidal silver containing no albumin precipitates on being boiled. Collargol solutions brought once to the boiling point present no macroscopic changes, though they do decrease in stability. A colloidal suspension of collargol does not respond directly to the usual tests for silver. If the colloidal suspension is warmed with nitric acid a white cloudiness is produced, which clears completely on stand- ing, and the silver can then be demonstrated in the usual manner. If a fragment of collargol is heated on a platinum scoop, shining white metallic silver of the ordinary kind, insoluble in water, is at once formed. Its colloidal suspension should not be exposed to light, or air; it is incompatible with the usual silver reagents. Collargol Ointment. — Unguentum Crede.— Ointment of Colloidal Silver. — Collargol ointment is an ointment containing 15 per cent of collargol. Collargol ointment is prepared by incorporating 15 parts of collargol with 5 parts of water, 10 parts of white wax and 70 parts of ben- zoinated lard, taking care that the soluble silver shall not be trans- formed into metallic silver of the ordinary kind. This, it is asserted, is liable to occur unless great care is observed in the manipulation. The natural color of collargol ointment is reddish brown. The oint- ment is good as long as it colors the skin black. LUNOSOL. — Argenti Chloridum Colloidale Sacchara- tum-Hille. — A preparation of colloidal silver chloride contain- ing silver chloride, 10 per cent, and sucrose, 90 per cent. Actions and Uses. — Lunosol has antiseptic and germicidal properties. It causes neither irritation of the mucous mem- branes nor coagulation of albumin even in concentrated solu- tions ; it does not stain the skin on topical application, but, as with any silver preparation, there is danger of argyria when it is applied to mucous membrane. Lunosol is intended for the prophylaxis against and treatment of infections of the accessible mucous membranes, such as the genito-urinary tract and the eye, ear, nose and throat. Dosage. — Lunosol is generally used in solutions (colloidal suspensions) of from 1 to 25 per cent. In the male urethra, from 3 to 25 per cent solutions are used ; for irrigation of the vagina, a 1 per cent solution is used, and on tampons, a 10 per cent solution; for irrigation of the bladder, a 0.1 to 1 per cent SILVER PREPARATIONS 429 solution, and for irrigation of the rectum, a 1 to 5 per cent solution is used ; in ophthalmia neonatorum, 25 to 50 per cent solutions are applied ; in pyelitis, 3 to 10 per cent solu- tions are injected into the kidney pelvis; for application to the nose, eye and ear, the average concentration is 10 per cent. Manufactured by Hille Laboratories, Inc., Chicago. No U. S. patent. U. S. trademark 189,347. Lunosol is a white, slightly hygroscopic, granular powder, odorless, having a sweetish, metallic taste. It is completely soluble in one half of its weight of water, forming an opalescent solution (colloidal sus- pension) which is bluish white in reflected light and reddish in trans- mitted light. If a solution of 0.5 Gm. of lunosol in 25 cc. of water is treated with 0.6 Gm. of potassium iodide dissolved in a few cc. of water, a yellow liquid is formed. If 0.5 Gm. of lunosol is dissolved in 25 cc. of water and 8 cc. of strong ammonia water is added, a clear, colorless solution results. If a solution of 0.5 Gm. of lunosol in 10 cc. of water is treated with 15 cc. of tenth-normal sodium thiosulfate, a clear color- less solution results. Place a few drops of lunosol solution (1 in 10) in the nostril: no sensation of irritation is produced. To about 2 cc. of fresh undiluted egg white, add 1 cc. of lunosol solution (1 in 10); shake the mixture, then allow to stand for fifteen minutes and finally dilute with 15 cc. of water: no precipitate forms. Dissolve approximately 0.5 Gm. of lunosol, accurately weighed, in 25 cc. of water, add 8 cc. of stronger ammonia water followed by an excess of nitric acid. Collect, wash, dry and weigh the precipitate. The weight of silver chloride found corresponds to a content of 10 per cent of silver chloride in the specimen taken. NEO-SILVOL. — Colloidal silver iodide compound. — A com- pound of silver iodide with a soluble gelatin base, containing 18 to 22 per cent of silver iodide in colloidal form. Actions and Uses. — Neo-Silvol, even in concentrated solutions, causes neither irritation of mucous membranes nor coagulation of albumin. It does not stain the skin on topical application, but, as with any silver preparation, there is danger of argyria when it is applied to mucous membrane. Neo-silvol is intended for the prophylaxis against, and treat- ment of infections of accessible mucous membranes, especially of the genito-urinary tract and of the eye, ear, nose and throat. Dosage. — In the treatment of acute inflammations of the mucous membranes solutions of neo-silvol as strong as 50 per cent may be used. In inflammatory infections of the ear, nose and throat, 5 to 40 per cent solutions are used ; for irrigating sinuses 2 to 5 per cent ; for inflammatory conditions of the eye and conjunctival infections a strength of 10 to 40 per cent; in acute anterior urethritis, as an abortive measure, 20 per cent; for posterior urethritis or in the routine treatment of anterior urethritis, 10 per cent ; in the genito-urinary tract of the female, from 10 to 50 per cent; as urographic medium, 20 per cent. Solutions of neo-silvol are prepared by adding the substance to the required amount of water (hot, for concentrations of 25 per cent or over) and agitating the mixture until solution occurs. 430 NEW AND NONOFFICIAL REMEDIES Solutions tend to precipitate gradually after standing longer than a week. Local anesthetics should not be added to solu- tions of neo-silvol. Manufactured by Parke, Davis & Co., Detroit. U. S". patent 1,610,391 (December 14, 1926; expires 1943). U. S. trademark 157,369. Capsules Neo-silvol, 6 grains. Neo-Silvol Ointment 5 Per Cent: Neo-Silvol, 5 per cent, in a base composed of glycerin and benzoinated lard, hydrous wool fat and petrolatum. Neo-Silvol Vaginal Suppositories : Each suppository contains neo-silvol, 0.4536 Gm. (7 grains), in a base composed of gelatin, glycerin and water. Neo-silvol is prepared by heating freshly precipitated silver oxide with gelatin (which has been previously dissolved in a dilute alkaline solution) until the silver oxide has been reduced to a metallic silver in a colloidal state of subdivision. The solution is treated with iodine, which combines with the _ silver. The liquid is then evaporated to dryness in vacuo. The finished product contains from 1 to 3 per cent of combined iodine in excess of that required for combination with the silver. Neo-silvol occurs as pale yellow granules. In concentration up to 50 per cent neo-silvol forms with water almost colorless, milky or opalescent solutions (colloidal suspensions). Neo-silvol is insoluble in fixed oils,^ but slowly soluble in glycerin. Solutions of neo-silvol are not precipitated in the cold by strong acids or sodium chloride. If a solution of neo-silvol is treated with a solution of potassium hydroxide no precipitate of silver iodide is formed; if this solution is boiled for a few minutes, it darkens gradually, but no precipitate is formed unless it is allowed to stand for some time. If a solution of neo-silvol is treated with dilute hydrochloric acid silver iodide is not precipitated; if this mixture is now boiled, the silver iodide is gradu- ally precipitated. Dilute solutions of neo-silvol do not discolor in sun- light (absence of silver chloride and silver bromide). Transfer about 1 Gm. of neo-silvol, accurately weighed, to an 8 ounce Erlenmeyer flask containing 100 cc. water and heat on steam bath until "solution" is effected. Add 5 cc. of hydrochloric acid and boil gently over a flame for ten or fifteen minutes; cool; when sufficiently cool to handle, filter through a tared Gooch crucible containing a fairly thick pad of asbestos. Wash thoroughly with water acidulated with hydrochloric acid (0.3 per cent hydrochloric acid). Dry at 100 C. and weigh as silver iodide: the weight found is equivalent to 18 to 22 per cent of silver iodide. SILVER LACTATE. — Argenti Lactas. — Ag.C3H503+ H2O. — The silver salt of lactic acid. Actions and Uses. — Silver lactate is used as an active anti- septic. It is irritating if applied in substance to wounds. Dosage. — From 1 in 100 to 1 in 2,000 solutions. Silver lactate is prepared by dissolving freshly precipitated silver carbonate in a solution of lactic acid by the aid of heat, and concen- trating the solution until crystallization begins. The operation must be conducted in a darkened room. Silver lactate occurs in the form of crystalline needles, granular masses or crystalline powder; it dissolves in about 15 parts of water. Pure silver lactate when heated leaves a residue of metallic silver, weighing 50.2 per cent. It is usually colored somewhat brown and gives with water a brownish or reddish solution. The salt must be protected from the light. Silver Lactate-Merck. — A brand of silver lactate-N. N. R. On heating it yields from 50 to 51.5 per cent of metallic silver. Merck & Co., Inc., Rahway, N. J., distributor. No U. S. patent or trademark. SODIUM MORRHUATE 431 SILVER NITRATE.— "When powdered and dried to constant weight in the dark over sulfuric acid, contains not less than 99.8 per cent of AgNOa." U. S. P. For standards see the U. S. Pharmacopeia under Argenti Nitras. Silver Nitrate Applicators (Arzol) : Silver nitrate, 75%. and potassium nitrate, 25%, fused to one end of wooden sticks 3 and 6 inches long, respectively. Each applicator is to be used but once. Prepared by The Arzol Chemical Company, Nyack, N. Y. (J. Sklar Manufacturing Company, Brooklyn, N. Y., distributor.) Ampoule Solution Silver Nitrate 1 Per Cent-Cutter: Solution silver nitrate 1 per cent, approximately 0.2 cc, contained in ampules composed of beeswax. For the prevention of ophthalmia neonatorum, two drops are placed in each eye after preliminary cleansing. Prepared by Cutter Laboratories, Berkeley, Calif. No U. S. patent or trademark. Ampule Solution Silver Nitrate 1 Per Cent-Lederle: Solution silver nitrate 1 per cent approximately 0.2 cc. contained in ampules composed of beeswax. A pinhole is made at one end of this ampule, and, after suit- able preliminary cleansing of the eye, two drops are placed in each eye of the newborn. Prepared by Lederle Laboratories, Inc., Pearl River, N. Y. No U. S. patent or trademark. Capsules Solution Silver Nitrate, 1 Per Cent-P. D. &■ Co., 6 minims: The aqueous solution of silver nitrate is contained in capsules composed of beeswax with an inner lining of paraffin. For use in prophylaxis against ophthalmia neonatorum, a pinhole is made in one end of the cap- sule and three drops of the solution placed in the eye of the newborn. Prepared by Parke, Davis & Co., Detroit. U. S. patent 1,527,659 (Feb. 24, 1925; expires 1942). No U. S. trademark. Ampoule Solution Silver Nit/ate 1 Per Cent-Sharp & Dohme : Solution silver nitrate 1 per cent, approximately 0.2 cc, is contained in ampules composed of beeswax. For use, a pinhole is made at one end of the ampule, and after suitable preliminary cleansing of the eye, two drops are placed in each eye of the new-born. Prepared by Sharp & Dohme, Inc., Philadelphia, Pa. No U. S. patent or trademark. SODIUM MORRHUATE. — The sodium salt of the unsaturated fatty acids occurring in cod liver oil. Actions and Uses. — The action of sodium morrhuate is that of a sclerosing agent. It is employed in solution with addition of a local anesthetic for the obliteration of varicose veins. Dosage. — One half to 1 cc. of a 5 per cent solution. Sodium morrhuate is a pale, yellowish, granular powder, possessing a slight fishy odor. It is soluble in water. Incinerate about 1 Gm. of sodium morrhuate: the residue responds to test for sodium carbonate. Dissolve about 0.01 Gm. of sodium morrhuate in 10 cc. of water, add 1 cc. of chloroform followed by one drop of sulfuric acid and shake: a violet-red color results, gradually changing to a reddish brown. Dry about 1 Gm. of sodium morrhuate, accurately weighed, at 100 C, for six hours: the loss does not exceed 2 per cent. Weigh accurately about 1 Gm. of sodium morrhuate in a tared platinum dish, add 10 cc. of sulfuric acid, gently heat while fumes of sulfur trioxide are evolved. 432 NEW AND NONOFFICIAL REMEDIES repeat, using two portions of 2 cc. of sulfuric acid, respectively, ignite, cool and weigh as sodium sulfate: the sodium found corresponds to not less than 7 per cent, nor more than 7.8 per cent, when calculated to the dried substance. Transfer about 25 Gm. of sodium morrhuate to a suitable Squibb separatory funnel, add 350 cc. of water and sufficient diluted sulfuric acid to precipitate the fatty acids, and extract with 3 portions of ether, using 150 cc, 100 cc, and 50 cc, respectively. The combined ethereal solutions, evaporated to an oily liquid on the steam-bath, conform to the following requirements: Morrhuic acid, a component of sodium morrrhuate, responds to the following tests for identity, purity and assay: Morrhuic acid occurs as a light amber oily liquid, possessing a slight fishy odor and taste; soluble in alcohol, carbon tetrachloride, chloroform and ether, practically insoluble in water. The specific gravity is 0.898 to 0.907 at 25 C. Incinerate about 0.5 Gm. of morrhuic acid, accurately weighed: the residue does not exceed 0.2 per cent. Dissolve about 0.1 Gm. of morrhuic acid, accurately weighed, in a dry 500 cc. glass stoppered flask, add 10 cc. of chloroform, followed by the addition of 25 cc. of iodochloride test solution (Wijs modification), accurately measured, stopper the flask and allow to stand for thirty minutes in a cool place protected from light. To the mixture add 20 cc. of a 15 per cent solution of potassium iodide, mix thoroughly, add 200 cc. of water, previously boiled and cooled, and titrate the excess of iodine with tenth-normal sodium thiosulfate solution, using starch paste as an indi- cator. While the foregoing is being performed, make a control test by using exactly the same quantities of reagents and titrate the free iodine with tenth-normal sodium thiosulfate solution: the amount of tenth-normal sodium thiosulfate solution consumed corresponds to an iodine value of not less than 145 and not more than 185. Dissolve about 1 Gm. of morrhuic acid, accurately weighed, in 50 cc. of alcohol and titrate with tenth-normal potassium hydroxide solution, using phenolphthalein as an indicator: the amount of tenth-normil potassium hydroxide solution consumed corresponds to a neutraliza- tion value which should not be less than 188 and not more than 193. Digest about 5 Gm. of morrhuic acid under a reflux condenser with a solution of about 2 Gm. of potassium hydroxide in 40 cc. of alcohol for an hour or until saponified. Evaporate most of the alcohol, dis- solve the residue in 50 cc. of hot water; transfer the solution to a separatory funnel, rinsing the flask with 25 cc. to 50 cc. of hot water; cool; extract with ether, using 2 portions of 50 cc. each, adding if necessary about 5 cc. of alcohol to facilitate the separation of two liquids; wash the combined ether extraction with small portions of water until not reddened by phenolphthalein; transfer the ethereal solution to a tared beaker; evaporate the ether on a water bath; dry the residue at a temperature not exceeding 100 C., and weigh: the unsaponi- fiable matter does not exceed 1.5 per cent. Ampules Sodnini Morrhuate 5% with Benzyl Alcoh-ol (Searle) 5 cc: Each cc. contains 0.05 Gm. sodium morrhuate and benzyl alcohol 0.02 Gm. in aqueous solution. Prepared by G. D. Searle & Co., Chicago. No U. S. patent or trade- mark. Sodium Morrliuate 5% Solution with Benzyl Alcohol (Uhner) 5 cc. Vials: Each cubic centimeter contains sodium morrhuate-N. N. R. 0.05 Gm., benzyl alcohol 0.03 Gm., and phenol 0.005 Gm., in aqueous solution. Prepared by the Ulmer Pharmacal Co., Minneapolis. No U. S. patent or trademark. Sodium Morrhuate 5% Solution ztnth Benzyl Alcohol (Ulmer) 20 cc. Vials: Each cubic centimeter contains sodium morrhuate-N. N. R. 0.05 Gm., benzyl alcohol 0.03 Gm., and phenol 0.005 Gm., in aqueous solution. Prepared by the Ulmer Pharmacal Co., Minneapolis. No U. S. patent or trademark. SULFOICHTHYOLATE PREPARATIONS 433 SODIUM THIOSULFATE. — "Sodium Hyposulfite." — "When rendered anhydrous by drying to constant weight at 100° C, contains not less than 99 per cent of NaoSaOs. It contains not less than 2>2 per cent and not more than 2i7 per cent of water." U. S. P. For standards see the U. S. Pharmacopeia under Sodii Thiosulfas. Ampules Sodium Thiosulphatc (Searlc), 5 cc. Prepared by G. D. Searle & Co., Inc.. Chicago. Ampules Sodium Thiosulphate (Searle), 10 cc. Prepared by G. D. Searle & Co., Inc.. Chicago. SULFOICHTHYOLATE PREPARATIONS AND SUBSTITUTES Preparations containing as their essential constituents salts or compounds of a mixture of acids containing sulfur and designated by the group name "sulfoichthyolic acid" are obtained from certain bituminous shales. Sulfoichthyolic acid is char- acterized by a high sulfur content, the sulfur existing largely in the form of sulfonates, sulfones and sulfides. The ammonium compound of this so-called sulfoichthyolic acid — first introduced as ichthyol — has been used most extensively. Compounds with sodium and other metals, with albumin, with formaldehyde, etc., have also been introduced. A number of more or less related compounds of sulfur have been introduced as substitutes for the sulfoichthyolates ; and the National Formulary contains a sulfoichthyolate preparation under the title, "Ichthammol." Actions and Uses. — The current estimate of the effects of sulfoichthyolic acid preparations is based largely on the use of ichthyol. The use of sulfoichthyolate preparations is still largely empiric. They are weakly antiseptic and emollient. Taken internally, they produce some gastro-intestinal irritation, with diarrhea, etc. They were formerly used locally under the supposition that they secure the absorption of swellings and effusions in con- tusions, burns, etc., and especially in gynecologic practice, and in various skin diseases. They have been tried internally in a great variety of conditions, but there is no evidence that they are of any therapeutic value when used in this way.. ICHTHAMMOL.— Bitumen Sulphonatum, N. F. V.— Ammonium Ichthosulfonate. — "Ichthammol is obtained by the destructive distillation of certain bituminous schists, sulfonating the distillate, and neutralizing the product with ammonia." N. F. For standards see the National Formulary under Ichthammol. Actions and Uses.— See general article. Sulfoichthyolate Prep- arations and Substitutes. 434 NEW AND NONOFFICIAL REMEDIES Hirathiol. — Ammonii Sulfoichthyolicum. — A brand of Ichthammol, N, F. Manufactured by Hirasawa Chemical Industrial Company, Tokyo, Japan (Takamine Laboratory, Inc., Clifton, N. J., U. S. selling agent). No U. S. patent. U. S. trademark 117,964. Hirathiol is a brownish-black syrupy liquid, having a characteristic empyreumatic odor. It is soluble in water, glycerin and alcohol. It is miscible with fats. The aqueous solution of hirathiol (1 in 10) is faintly acid to blue litmus. The aqueous solution (1 in 20) yields a greenish-black, resin- like precipitate on the addition of hydrochloric acid. This precipitate is soluble in ether; it is also soluble in water, but if dissolved in the latter solvent, it is again precipitated by the addition of hydrochloric acid or sodium chloride solution. Boil an aqueous solution of hirathiol (1 in 10) with potassium hydrox- ide solution: ammonia is evolved. Hirathiol is decomposed by acids, saline solutions, and fixed alkalis. Hirathiol loses 46.5 per cent of its weight when dried at 100 C. Weigh from 5 to 6 Gm. of hirathiol into a flask, and 25 cc. of potassium hydroxide solution and 100 cc. of water. Distil the mixture until no more ammonia passes over, collect the distillate in 15 cc. cf normal sulfuric acid, to which 1 drop of methyl orange solution has been added, and titrate the excess of acid with tenth-normal potassium hydroxide: the amount of normal sulfuric acid consumed corresponds to 3.18 per cent of total ammonia (NHs). Weigh from 5 to 6 Gm. of hirathiol into a beaker, add 50 cc. of water and 10 cc. of a 10 per cent solution of albumin, followed by 5 portions of 5 cc. each of diluted hydrochloric acid, shaking after each addition. Make up the mixture to a volume of 500 cc. and filter through a dry filter. Heat 200 cc. of the filtrate to boiling, add 10 cc. of barium chloride solution and allow the mixture to stand for twenty- four hours. Collect the precipitate of barium sulfate, heat and weigh: The weight of barium sulfate obtained corresponds to 6.16 per cent of ammonium sulfate. Weigh from 0.5 to 1 Gm. of hirathiol into a Kjeldahl flask, add 30 cc. of water and 5 Gm. of potassium chlorate followed by 30 cc. of nitric acid, and evaporate the mixture to about 5 cc; add 25 cc. of hydrochloric acid and evaporate to 5 cc. ; again add 25 cc. of hydro- chloric acid and evaporate to 5 cc. Then add 100 cc. of water, heat to boiling and add 10 cc. of barium chloride solution, allow themixture to stand for twenty-four hours, collect the precipitate of barium sul- fate, heat and weigh: the weight of barium sulfate corresponds to 10.23 per cent of total sulfur. Calculate the ammonia obtained in the ammonium sulfate, as pre- viously determined in hirathiol, and subtract the result from "total ammonia" as previously determined. Multiply the remainder by the factor 1.88: the result represents the sulfur present as "sulfonic sulfur." Calculate the sulfur contained in the ammonium sulfate as previously determined in hirathiol, and subtract the result from "total sulfur" as previously determined: the remainder (8.74 per cent) represents the sulfur present in the organic, sulfonic acids con- tained in the substance. Subtract the "sulfonic sulfur" as previously calculated, from the sulfur in the organic acids, as previously calcu- lated: the remainder corresponds to 5.73 per cent of organic ("sul- fide") sulfur. Ichthynat. — Ammonium Ichthynatum. — A brand of Ich- thammol, N. F. Manufactured for the Heyden Chemical Corporation, New York. No U. S. patent. U. S. trademark 44,053. Ichthynat is a brown-black, syrupy liquid, having a characteristic empyreumatic odor and burning taste. SULFOICHTHYOLATE PREPARATIONS 435 It is completely soluble in water; incompletely soluble in alcohol or ether, but nearly soluble in a mixture of equal volumes of alcohol and ether; also soluble in a mixture of equal volumes of alcohol, water and ether. It is miscible with glycerin. Ichthynat is decomposed by acid and saline solution, fixed alkalis, their carbonates and iodides, alkaloidal salts and mercuric chloride. The aqueous solution of ichthynat (1 in 10) has a faintly acid reac- tion on blue litmus paper. The aqueous solution of ichthynat (1 in 10) yields a greenish-black, resin-like precipitate on the addition of hydro- chloric acid. This precipitate is soluble in ether; it is partially soluble in alcohol; soluble in water, but if dissolved in the latter solvent it may again be precipitated from solution by the addition of hydrochloric acid or sodium chloride solution. With barium chloride solution the aqueous solution of ichthynat (1 in 10) gives a brownish-like pre- cipitate which is insoluble in diluted hydrochloric acid. If the aqueous solution of ichthynat (1 in 10) is boiled with potassium hydroxide solu- tion, ammonia is evolved. If 1 Gm. of ichthynat is ignited it will leave not more than 0.5 per cent of residue. If 10 Gm. of ichthynat is diluted with 90 cc. of water, the mixture placed in a glass-stoppered cylinder and allowed to remain undisturbed for twenty-four hours, no deposit will form. If dried at 100 C, ichthynat will not lose more than 47.0 per cent of its weight (absence of an undue amount of water). If from 5 to 6 Gm. of ichthynat is weighed into a flask, and 25 cc. of potassium hydroxide solution and 100 cc. of water is added, the mixture distilled until no more ammonia passes over, the distillate collected in 15 cc. of normal sulfuric acid to which 1 drop of methyl orange solution has been added and the excess of acid then titrated with tenth-normal potassium hydroxide, the amount of normal sulfuric acid consumed will correspond to from 3 to 5 per cent of total ammonia (NHs). If from 5 to 6 Gm. of ichthynat is weighed into a beaker, diluted with 50 cc. of water, 10 cc. of a 10 per cent solution of dried egg albumin added, followed by five portions of 5 cc. each of diluted hydrochloric acid, shaking after each addition, the mixture made up to a volume of 500 cc. and filtered through a dry filter, and if 200 cc. of the filtrate is heated to boiling, and 10 cc. of barium chloride solution is added, the mixture allowed to stand for twenty-four hours, the pre- cipitate of barium sulfate collected, heated and weighed in the usual way, the weight of barium sulfate obtained will correspond to from 5 to 7 per cent of ammonium sulfate. If from 0.5 to 1 Gm. of ichthynat is weighed into a Kjeldahl flask, diluted with 30 cc, of water, and 5 Gm. of potassium chlorate added, followed by 30 cc. of nitric acid, the mixture evaporated to about 5 cc, and 25 cc. of hydro- chloric acid added, this solution evaporated to about 5 cc, 25 cc. of hydrochloric acid again added, this solution evaporated to about 5 cc, 100 cc. of water added, this solution heated to boiling, 10 cc. of barium chloride solution added, the mixture allowed to stand for twenty-four hours, the precipitate of barium sulfate collected, heated and weighed in the usual way, the weight of barivim sulfate will correspond to from 8 to 10 per cent of total sulfur. If the ammonia contained in the ammonium sulfate as previously determined in ichthynat is calcu- lated, and the result subtracted from the "total ammonia" as previously determined, the remainder will represent the ammonia combined with the organic-sulfonic acids. If this value is multiplied by 1.88, the result (from 3 to 5 per cent) will represent the sulfur present in the sulfonic acids in an oxidized state, i. e., the "sulfonic sulfur." If the sulfur contained in the ammonium sulfate as previously deter- mined in ichthynat is calculated, and the result subtracted from the "total sulfur" as previously determined, the remainder will represent the sulfur present in the organic sulfonic acids contained in the sub- stance. If the "sulfonic" sulfur in ichthynat as previously calculated is subtracted from the sulfur in the organic-sulfonic acids as previously calculated, the remainder will correspond to at least 5 per cent of "organic" ("sulfide") sulfur. 436 NEW AND NONOFFICIAL REMEDIES Ichthyol. — A brand of Ichthammol, N. F. Manufactured by the Ichthyol Company, Rahway, N. J. (Merck & Co., Inc., Rahway, N. J., distributor). No U. S. patent. U. S. trademark 62,603. Ichthyol conforms to the standards of Ichthammol, N. F. VI, and in addition to the following standards: Dissolve 10 Gm. of ichthyol in 90 cc. of water, in a glass-stoppered cylinder and allow to remain undisturbed for twenty-four hours: no deposit forms. Transfer 0.5 to 1 Gm. of ichthyol accurately weighed to a Kjeldahl flask, dilute with 30 cc. of water, add 5 Gm. of potassium chlorate and 30 cc, of hydro- chloric acid, evaporate the mixture to about 5 cc, add 25 cc. of hydrochloric acid, evaporate this solution to about 5 cc, again add 25 cc. of hydrochloric acid, evaporate to about 5 cc, then add 100 cc of water; heat the solution to boiling, add 10 cc. of barium chloride solution, allow the mixture to stand twenty-four hours: the weight of the precipitated barium sulfate determined in the usual way will correspond to at least 10 per cent of total sulfur. If the ammonia contained in the ammonium sulfate as previously determined in ichthyol is calculated, and the result substracted from the "total ammonia" as previously determined, the remainder will represent the ammonia com- bined with the organic sulfonic acids. If this value is multiplied by 1.88 the result will represent the sulfur present in the sulfonic acids in an oxidized state; i. e., the "sulfonic sulfur." If the sulfur con- tained in the ammonium sulfate as previously determined in ichthyol is calculated, and the result subtracted from the "total sulfur" as pre- viously determined, the remainder will represent the sulfur present in the organic sulfonic acids contained in the substance. If the "sulfonic" sulfur in ichthyol as previously calculated is sul)tracted from the sulfur in the organic-sulfonic acids as previously calculated, the remainder will correspond to at least 5.5 per cent of "organic" ("sulfide") sulfur. Isarol-Ciba. — A brand of Ichthammol, N, F. Manufactured by the Society of Chemical Industry in Basle, Switzer- land (Ciba Company, Inc, New York), No U, S. patent, U, S. trade- mark, 97,007. Isarol-Ciba is a reddish-brown to brownish-black syrupy liquid with a strong characteristic empyreumatic odor. It is soluble in water and in glycerin, and is miscible with fixed oils and fats. It is partly soluble in alcohol or ether, and entirely soluble in a mixture of equal volumes of these solvents. An aqueous solution (1 in 10) may be faintly acid or faintly alkaline to litmus paper. The addition of hydrochloric acid to this solution precipitates a dark resinous mass which is soluble in ether. Incinerate a weighed portion of isarol-Ciba: the ash does not exceed 0.5 per cent. Dry a weighed portion on a water bath to constant weight: the loss is not more than 50 per cent. Accurately weigh about 5 Gm. of isarol-Ciba, dissolve in 100 cc. of water, transfer to a distillation flask, add an excess of sodium hydroxide solution and distil slowly; collect the distillate (about 50 cc.) in 15 cc of normal sulfuric acid; when the distillation is completed, titrate the excess of sulfuric acid with tenth-normal sodium hydroxide, using methyl orange as indicator: the amount of ammonia found is not less than 2.5 per cent. Accurately weigh about 1 Gm. of isarol-Ciba; transfer to a 100 cc, beaker and add 25 cc, of alcohol; stir thoroughly, filter, and wash the filter with a mixture of equal parts of ether and alcohol until the washings are clear and colorless; dry the residue on the filter at 100 C, cool, and wash the_ filter with 200 cc. of warm water slightly acidulated with hydrochloric acid; determine the sulfate in the solution by precipitation with barium chloride solution, and after washing, drying, igniting and weighing, calculate the results to ammo- nium sulfate: the amount found is not more than 8 per cent. Dry about 1 Gm. of isarol-Ciba on a watch glass to constant weight at 105 C. ; pulverize the dried material and transfer about 0.5 Gm., accu- rately weighed, to a nickel crucible; add about 9 Gm. of sulfur-free sodium peroxide, and mix thoroughly; place the crucible carefully in a beaker containing cold distilled water, which should reach about half- way to the top; ignite the dry mixture in the crucible by thrusting a SULFONMETHANES 437 red hot iron wire through a hole in the cover of the crucible; after complete combustion has taken place, tip the crucible and allow the fused mass to dissolve in the distilled water; add hydrochloric acid in slight excess, heat to boiling, and determine the sulfate in the solution by precipitation with barium chloride solution, and after washing, drying, igniting and weighing, calculate the results to sulfur: the total sulfur should not be less than 10 per cent. THIGENOL-ROCHE. — Solution of Sodium Sulfo- Oleate-Roche. — A solution of the sodium salts of synthetic sulfo-oleic-acids, containing 2.85 per cent of sulfur. Actions and Uses. — See preceding article, Sulfoichthyolate Preparations and Substitutes. Manufactured by F. Hofifmann-La Roche & Co., Basle, Switzerland (Hoffmann-La Roche, Inc., Nutley, N. J,, distributor). No U. S. patent. L;. S. trademark 80,424. Precipitated sulfur is dissolved by boiling in the glyceride of oleic acid; the resulting solution is treated with sulfuric acid, during which process sulfurous acid escapes, and a sulfo-oleic acid is separated out. The separated sulfo-acid is then obtained by pouring into water and subsequently washing thoroughly. By treatment with solution of sodium hydroxide, there results a solution of sodium sulfo-oleate, which is evaporated in vacuo until it has a specific gravity of from 1.05 to 1.06. Thigenol is a dark brown liquid, having a faint sulfurous odor, It is soluble in one or more parts of water, dilute alcohol, glycerin, chloroform, or oily or fatty bases, with any one of which it mixes freely. When water is the vehicle employed, it should be distilled; hard water will cause a precipitate. Thigenol is incompatible with mineral acids or acetic acid. SULFONMETHANES Two analogous compounds formed by the substitution of sulfone radicals in methane have been applied in therapeutics. The first, sulfonmethane-N. F. (sulfonal) is diethylsulfon- dimethylmethane ; the second, sulfonethylmethane-U. S. P. (trional) is diethylsulfonemethylethylmethane. The latter has been generally given the preference, Sulfonmethane is soluble with difficulty and slowly absorbed and its hypnotic action is but slowly established ; sulfonethyl- methane is somewhat more soluble than sulfonal and acts more quickly. Both drugs are preferably given in hot liquids ; and in the case of sulfonmethane, the hypnotic effect is likely to be postponed for several hours. Sometimes it is not developed until the following day, Sulfonethylmethane is usually effec- tive in an hour or two. The sulfonmethanes in therapeutic doses produce sleep without noticeable effect on the circulation or respiration. In larger doses, acute poisoning occurs, evidenced by disturbances of the digestive organs, the metabolism and the nervous system. When administered for too long a period, cumulation is likely to occur, producing a condition of chronic poisoning which terminates fatally in a large percentage of cases. In such cases, hematoporphyrin derived from hemoglobin turns the urine 438 NEW AND NONOFFICIAL REMEDIES pink or red. This should serve as a warning, indicating the immediate withdrawal of the drug. The symptoms of poisoning consist of persisting confusion, ataxia, constipation, vomiting, albuminuria and nephritis. Dosage. — The usual dose of either sulfonmethane or sulfon- ethylmethane is 1.0 Gm, with a maximum of 2 Gm. for the first and 4 Gm. for the second. When these drugs are used frequently, the administration should be suspended once in two or three days to allow of complete elimination, and the urine should be examined frequently for hematoporphyrin. SULFONMETHANE. — For standards see the National Formulary under Sulfonmethanum. Actions, Uses and Dosage. — See preceding article, Sulfon- methanes. Sulfonal. — A nonproprietary name applied to sulfon- methane. SULFONETHYLMETHANE. — Diethylsulfonmethyl- ethylmethane. — For standards see the U. S. Pharmacopeia under Sulfonethylmethanum. Trional. — A nonproprietary name applied to sulfonmethyl- methane. TANNIC ACID DERIVATIVES The pharmacologic actions of tannic acid are due to its property of precipitating protein. Its most important use is in the treatment of burns, for which the free tannic acid must be employed. Internally, tannic acid has been used in diarrhea ; but if tannic acid is given as such, it is rapidly dissolved in the stomach, and may then produce excessive gastric irritation, nausea and even vomiting. The desire to avoid these effects has prompted the introduction of relatively insoluble compounds of tannin, which would act but little, if at all, in the stomach ; and whose action would extend farther down the intestines. This was sought to be accomplished by utilizing the differences in reaction (hydrogen ion concentration) at the various levels of the alimentary tract. It was therefore aimed to make the compounds insoluble in diluted acids, and soluble in diluted alkalis. This object has not been entirely attained and is prob- ably not really desirable in view of the frequent slightly acid reaction of the intestinal contents. It is probably more impor- tant that the compounds should be but slowly soluble in any reaction that occurs in the alimentary tract. Types of Tannic Acid Derivatives. — Four types have been marketed: (1) organic esters of tannic acid, represented by acetyltannic acid (acetyltannic acid-U. S. P., tannigen) ; (2) coagulated tannin proteinate, represented by exsiccated tannin albuminate (albumin tannate-U. S. P.) ; (3) tannin caseinate TANNIC ACID DERIVATIVES 439 (protan) ; and (4) a heterogenous group of other compounds, such as bismuth salts of tannic acid, etc. The chief criteria for evaluating the tannic acid compounds are their solubilities or speed of hydrolysis during various reaction periods in acid and alkaline solution, with or without the addition of ferments. Importance of Differences in Solubility. — All the compounds are somewhat soluble in water ; but not sufficiently soluble to affect their therapeutic usefulness. From the latter stand- point, the solubility in acid gastric juice and the solubility in sodium bicarbonate solution, representing the maximum alkalinity of the intestines, are most important. The speed or slowness of solution is at least as important as the abso- lute solubility. Insolubility in acid gastric juice would be desirable, theo- retically, by precluding gastric side effects. In fact, however, it is probably not important, provided that the solution is slow, or that the tannic acid is taken with food. Of the three types, the acetyltannic acid-U. S. P. is the least soluble in gastric juice; albumin tannate-U. S. P. is fairly soluble, but the solution occurs rather slowly ; protan is the most soluble, and the solu- tion occurs more rapidly. Solubility in sodium bicarbonate solution is, of course, necessary ; in fact, the fraction that does not dissolve is merely inert ballast in the therapeutic use which could, how- ever, be compensated by increasing the dose (all three classes contain about half their weight of tannic acid). The most important point is, therefore, the speed of solution. The more rapidly the tannic acid is dissolved, the more intensely will it act on the upper intestines, and the less on the lower portions. In the case of acetyltannic acid, the ester must also be hydrolyzed before it becomes astringent. The rate of this hydrolysis of acetyltannic acid-U. S. P. is about the same as that of the solution of albumin tannate-U. S. P., in both cases requiring more than three hours for completion. Under clinical conditions a larger part of the albumin tannate-U. S. P. will have been dissolved in the stomach, and it will thus exert a rather stronger action in the duodenum, and probably extend its action slightly less into the lower intestines. Clinically, how- ever, the difference does not seem to be large. Protan, on the other hand, dissolves completely within half an hour, so that its action would be much greater in the upper and much less in the lower intestines. Distinctive Differences in Solubility. — All the compounds are somewhat soluble in water ; acetyltannic acid-U. S. P., not more than 7,5 per cent; albumin tannate-U. S. P., not more than 20 per cent; protan about 16 per cent. Artificial gastric juice (acid-pepsin solution) dissolves : acetyltannic acid-U. S. P., less than 7.5 per cent, in two hours; albumin tannate-U. S. P., less than 25 per cent, in one-half hour; less than 38 per cent, in two hours ; protan, about 60 per cent, in one-half hour, about 72 per cent, in two hours. Dilute alkali (1 per cent sodium 440 NEW AND NONOFFICIAL REMEDIES bicarbonate) hydrolyzes from 33 to 50 per cent of acetyltannic acid-U. S. P. in one-half hour ; 75 per cent is hydrolized and 85 per cent dissolved in three hours. Of albumin tannate- U. S. P., it dissolves from 35 to 50 per cent in one-half hour and more than 70 per cent in two hours. Of protan, it dissolves 98 per cent in one-half hour. Actions and Uses. — The sparingly soluble tannic acid prep- arations are used in diarrheal affections, particularly those of children. They should not be employed as the principal cura- tive agent, but as an occasional adjunct to the proper physical and dietetic remedies, when the discharges are unduly profuse. As has been explained, acetyltannic acid-U. S. P. and albumin tannate-U. S. P. act at all levels of the intestine. Acetyltannic acid might be expected to act somewhat more mildly in the duodenum, and to extend its action somewhat more effectively into the lower intestine ; but clinically there does not seem to be much, if any, difference. Protan would tend to expend its action mainly on the upper intestine. ACETYLTANNIC ACID.— Diacetyltannic Acid.— Tannyl Acetate. — Acetannin. — "A product obtained by the acetylation of tannic acid." U. S. P. For standards see the U. S. Pharmacopeia under Acidum Acetyltannicum. Actions and I'scs. — See preceding article, Tannic Acid Derivatives. Dosage. — From 0.2 to 0.7 Gm. (3 to 10 grains), four times per day, taken dry on the tongue followed by a swallow of water, or mixed with food, avoiding warm or alkaline liquids. Tannigen.— A brand of acetyltannic acid-U. S. P. Manufactured by Winthrop Chemical Company, Inc., New York. U. S. patent expired. PROTAN.— Tannin Nucleo-Proteid-Mulford.— A chemical combination of casein with tannic acid containing about 50 per cent tannic acid. Actions^ and Uses. — Protan is said to be useful as an intes- tinal astringent in all forms of diarrhea. Dosage. — For infants and children, from 0.3 to 0.6 Gm. (5 to 10 grains) every hour; in acute catarrhal diarrhea (cholera morbus), from 1 to 2 Gm. (15 to 30 grains) every one or two hours; in chronic diarrhea, from 1.3 to 2 Gm. (20 to 30 grains) every hour or two hours. Manufactured by Sharp & Dohme, Philadelphia and Baltimore. No U. S. patent. U. S. trademark 38,616. Compressed Tablets, Protan, 5 grains. Protan is made by adding a solution of tannic acid to an alkaline solution of casein, collecting and drying the precipitate. It is a light brown powder, tasteless, and free from astringent action on the mouth and stomach; insoluble in water or dilute acids, and does not coagulate albumin or precipitate pepsin or peptones. TETRACHLORETHYLENE 441 When protan is shaken with water and filtered, a colorless solution should be obtained, which should give not more than a faint trace of color with ferric chloride solution, showing absence of more than traces of free (uncombined) tannic acid. The resistance of protan to the action of the gastric juice may be shown by mixing 2 Gm. (dried at 100 C.) with 40 cc. of 0.2 per cent hydrochloric acid containing ten times the theoretical amount of 1 in 3,000 pepsin necessary to digest the protein present, warming to 40 C. for six hours, filtering off the residue, drying and weighing; from 60 to 70 per cent of the amount taken may thus be recovered. The tannin may best be deter- mined by difference, the casein being determined by decomposing it by the Kjeldahl-Gunning method and estimating the nitrogen. TETRACHLORETHYLENE.—". . . contains not less than 99 per cent and not more than 99.5 per cent of CCI2 : CCU', the remainder consisting of alcohol." A^. F. For standards see the National Formulary under Tctra- chlorethylenum. Actions and Uses. — Observations of many workers have shown that tetrachlorethylene is a useful anthelmintic for the treatment of hookworm infestation. It has been used against other worms with less success, although there is some evidence that it is useful in Trichuris infestation. It may be lethal to Ascaris but its use in that infestation is not advised because of the danger of causing migration of the worms. It is the con- sensus of the investigators that tetrachlorethylene is less toxic than carbon tetrachloride (CCU) and at least as efficacious as the latter drug. It has a further advantage over carbon tetra- chloride in that it does not lower the guanidine content of the blood, which is important in cases exhibiting a calcium deficiency. Untoward reactions are rare, but giddiness, vomit- ing and drowsiness have been reported in some cases. It is probably better to keep the patient (especially children) in bed during the treatment. Dosage. — From 1 to 3 cc. depending on the age of the patient. Tetrachlorethylene is usually given in soft gelatin capsules but has also been administered to children on a lump of sugar. The gastro-intestinal tract should be thoroughly emptied before administering tetrachlorethylene. Fats and alcohol must be avoided, because they favor absorption of the drug. A dose of tetrachlorethylene should be followed by a saline cathartic of sodium or magnesium sulfate. One dose frequently suffices, but if necessary it may be repeated once after a period of from ten days to two weeks. Note. — Broken capsules should be discarded ; the solution should never be employed if it has been exposed to the air for more than a very brief time, because of the possibility of phosgene formation by decomposition. Tetrachlorethylene-Calco. — A brand of tetrachlorethylene N. F., marketed in soft gelatin capsules each containing 1 cc. of tetrachlorethylene. Manufactured by Calco Chemical Co.. Inc. (a division of the American Cyanamid Co.). Bound Brook, N. J. No U. S. patent or trademark. Tctrachlorcthylene-Calco, 1 cc. 442 NEW AND NONOFFICIAL REMEDIES THYROXINE Actions and Uses. — Thyroxine (Thyroxinum, U. S. P.) is used essentially for the same purpose as Thyroid-U. S. P., but the dosage may be more accurately determined and results more quickly obtained. It is indicated in cases of diminished or absent thyroid functioning, such as simple goiter, cretinism and myxedema. Reports show that thyroxine affects the pulse rate, blood pressure, nitrogen metabolism, relieves symptoms of myxedema and will produce hyperthyroidism. The most important quantitative measure is the determination of the basal metabolic rate. One milligram (0.001 Gm.) of thyroxine increases the basal metabolic rate in adults approximately 2 per cent. The relation holds for larger amounts, that is, 10 milli- grams increases the metabolic rate 20 per cent and it is through the basal metabolic rate that the pharmacologic action of thyroxine can be followed best. When given by mouth or intravenously, there is no immediate effect except occasionally when an increase in pulse rate and respiration occurs, which however, will soon disappear. After from twenty-four to thirty-six hours, there is a noticeable increase in pulse rate. There may be loss of weight and beginning of nervous mani- festations. If the dosage is continued for five or six days, the typical so-called hyperthyroid symptoms may be produced: loss of weight, increased pulse rate with tachycardia, nervous mani- festations and a sense of fatigue. With small doses, the harm- ful effects are not produced and a stimulating effect is manifest in cases of myxedema. The amount of thyroxine required to produce toxic effects is exceedingly small. It has been reported that the maximum effect from a single injection is not reached until the tenth day, the duration of the effects being about three weeks. In some forms of goiter (such as simple adolescent colloid goiter), the function of the thyroid is defective and the admin- istration of thyroxine is indicated ; but in many cases of goiter (especially exophthalmic) thyroxine should never be admin- istered. Dosage. — From 0.2 mg. to 2 mg. Thyroxine should always be given at first in minimum doses and in each case the optimum amount determined by trial. For the exact determina- tion of this dose, the establishment of the basal metabolic rate for each given case is necessary. In general a normal adult will show evidences of hyperthyroidism if given as much as 2 mg. per day. A person afflicted with high-grade myxedema requires from 1.5 to 2 mg. per day; a small cretin requires from 0.2 to 0.4 mg. every day or every other day. Thyroxine may be administered either by intravenous injec- tion or by mouth. In those cases in which thyroxine is not absorbed quantitatively when given by mouth it may be given intravenously as follows : Place a known amount of pure crystalline thyroxine — from 1 to 10 mg. — in a small sterile test THYROXINE 443 tube, such as is used for the Wassermann test. Add 1 drop of 10 per cent sodium hydroxide solution and about 1 cc. of water. Warm and agitate the solution until the crystals are dissolved, and then sterilize by placing the tube in boiling water. Transfer the solution to a sterile hypodermic syringe, rinse out the test tube with 1 cc. of sterile distilled water, adding this to the solution in the syringe, and then inject the contents of the syringe intravenously. In many cases, after symptoms of hypothyroidism have dis- appeared, remarkably small doses suffice to keep the patient in an almost normal state. The patient should be careful of exer- tion and should take sufficient protein in the diet to compensate for increased loss of nitrogen from the action of the drug. THYROXIN. — "An active physiological principle obtained from the thyroid gland, or prepared synthetically, and contains not less than 64 per cent of iodine as an integral part of the Thyroxin molecule." U . S. P. For standards see the U. S. Pharmacopeia under Thyroxinum. Thyroxin (Squibb). — A brand of thyroxin-U. S. P. Manufactured by E. R. Squibb & Sons, New York. SYNTHETIC THYROXINE-ROCHE.— iS[3', 5'-diiodo- 4'-)3,5 diiodo-4-hydroxyphenoxy) phenyl] -a-aminopropionic acid.— HOCeH2l2.0C6H2l2.CH2CH(NH2)COOH. A tetraiodo- derivative of /^-hydroxyphenyl ether of tyrosine; it contains not less than 65 per cent of iodine. Actions and Uses. — See preceding article. Thyroxin. Dosage. — See preceding article. Thyroxin. Manufactured by F. Hoffmann-LaRoche & Company, Basle, Switzer- land (Hoffmann-LaRoche, Inc., Nutley, N. J., distributor). No U. S. patent or trademark. Ampuls Synthetic Thyroxine-Roche, 1.1 cc: Each cubic centimeter contains 1 mg. of synthetic thyroxine-Roche. Solution Synthetic Thyroxine-Roche : Each cubic centimeter contains 2 mg. of synthetic thyroxine-Roche, Tablets Synthetic Thyroxine-Roche, 1 mg. Synthetic thyroxine is a white or slightly yellow, needle-like, odorless, crystalline powder. It is insoluble in water and practically insoluble in alcohol or the other more common organic solvents, but in the presence of mineral acids it dissolves in alcohol, is soluble in solutions of the alkali hydroxides, and on saturation with sodium chloride the sodium salt of thyroxine separates. Synthetic thyroxine melts with decomposition between 225 and 228 C. Transfer about 0.1 Gm. of synthetic thyroxine^ to a small hard glass test tube containing a piece of sodium about the size of a pea, previously melted; after the first violent action has ceased, heat until contents of test tube are decomposed: vapors of iodine are evolved; the tube and contents are allowed to cool; add 10 cc. of water ;_ the mixture is boiled for a few minutes; filter through paper and divide into two portions. To one portion add a few drops of sodium hydroxide solution followed by the addition of a few drops of freshly prepared ferrous _ sulphate solution and finally a few drops of ferric chloride solution and. after agitation, add just enough diluted hydrochloric acid to dis- solve the iron hydroxides: a very finely divided blue precipitate 444 NEW AND NONOFFICIAL REMEDIES results; to the other portion add 1 cc. of concentrated nitric acid, boil, cool and add 1 cc. of silver nitrate solution: a curdy yellow pre- cipitate results, insoluble in a large excess of stronger ammonia water. Add about 0.01 Gm. of synthetic thyroxine to 1 cc. of a one per cent solution of triketohydrindene-hydrate {Ninhydrin) solution and boil for one minute: a blue color results. Place about 0.03 Gm. of synthetic thyroxine in a 50 cc. glass stoppered cylinder, add 30 cc. of water, shake the contents for five minutes, filter through paper: separate portions of 2 cc. each of the filtrate yield no opalescence with 0.5 cc. of diluted nitric acid and 0.5 cc. of silver nitrate solution (soluble halides); no turbidity with 0.5 cc. of diluted nitric acid and 0.5 cc. of barium nitrate solution (sulfates); no coloration or precipitation on saturation with hydrogen sulfide (salts of heavy metals). Incinerate about 0.05 Gm. of synthetic thyroxine, accurately weighed; the residue is negligible. Dry about 0.05 Gm., accurately weighed, for 24 hours over sulfuric acid in a partial vacuum: the loss in weight should not exceed 1 per cent. Weigh accurately about 0.1 Gm. of the substance, previously dried for 24 hours over sulfuric acid, and transfer to a bomb tube: determine the iodine content by the Carius method: the amount of iodine found should not be less than 65 per cent, nor more than 66.5 per cent. THYROXINE CRUDE.— The partially purified disodium salt of thyroxine, approximately 25 per cent admixed with the acid-insoluble humus-like products of protein hydrolysis. Actions and Uses. — The same as those of thyroxine, except that it is not to be used for injection. In certain individuals in whom the thyroxine equivalent is not absorbed quantitatively, the pure crystalline thyroxine should be given intravenously (see under thyroxine). Dosage. — Thyroxine crude is supplied in the form of tablets for oral administration, representing a stated weight of thy- roxine. Thyroxine crude must not be administered intravenously. Manufactured by E. R. Squibb & Sons, New York, by license of the University of Minnesota. U. S. patents, 1,392,767 (Oct. 4, 1921; expires 1938), and 1,392,768 (Oct. 4, 1921; expires 1938). Thyroxine Tablets, 0.2 mg.: Each tablet contains thyroxine crude, equivalent to 0.2 mg. thyroxine. Thyroxine Tablets, 0.4 mg.: Each tablet contains thyroxine crude, equivalent to 0.4 mg. thyroxine. Thyroxine Tablets, 0.8 mg. : Each tablet contains thyroxine crude, equivalent to 0.8 mg. thyroxine. Thyroxine Tablets, 2.0 mg : Each tablet contains thyroxine crude. equivalent to 2.0 mg. thyroxine. Thyroid glands of animals are hydrolyzed by treatment with sodium hydroxide solution. The resulting soaps and alkali insoluble materials are removed. The clarified hydrolysate is precipitated with acid and filtered. The precipitation is twice repeated and the residue^ finally redissolved in a slight excess of sodium carbonate solution, dried and powdered. The thyroxine content is determined by the assay described below and the product made into tablets with sucrose and lactose as vehicles. Thyroxine crude is a light brown powder having a characteristic odor and an alkaline taste. It is soluble in water; decomposed by acids. The following method may be applied for the assay of thyroxine tablets : Weigh accurately five or ten tablets. Grind finely the tablets and weigh out a sample of the powdered thyroxine for analysis; place over sulfuric acid in a desiccator for twenty-four hours and determine loss in weight. Deliver the dried sample in a beaker and add 10 cc. sodium hydroxide solution, 30 per cent. Dissolve the sample by URETHANES, UREA AND UREIDS 445 "working" it with the aid of a glass rod; add 50 cc. of water. Filter the solution into a small beaker, wash the original beaker and filter paper with sodium hydroxide test solution. Make the filtrate faintly acid with dilute sulfuric acid solution; filter off the precipitate and wash it. Determine the iodine content in the precipitate according to the method of Kendall {Jour. Biol. Chem. 19:252, 1914), and calculate the amount of thyroxine in the dried specimen and in tablets. (The iodine in the precipitate is thyroxine iodine; any iodine in the filtrate is from other iodine containing compounds, and is physiologically inactive. Thyroxine tablets-Squibb contain a small amount of humus- like substance resulting from the hydrolysis of the protein.) URETHANES (CARBAMATES), UREA AND UREIDS The starting-point of this group is urea, which is carbamide, NH2CO.NH0. By the addition of a molecule of water to this compound, we have ammonium carbamate, NH2COOXH4; sub- stitution of ethyl for ammonium yields ethyl carbamate (ure- thane), NHsCCOCCoHs). By substitution of phenyl for hydrogen, we get NH(C6H5).CO.O(C2H5), phenyl urethane or phenyl ethyl carbamate. By substituting for the ethyl of urethane the radical of methyl propyl carbinol, we get methyl propyl carbinol urethane, XH2.CO.O.CH(CH3)CH2.CH2CH3 or hedonal. Urethanes are diuretic and hypnotic agents. They are oxi- dized in the system to carbon dioxide and urea. Urethane is a comparatively feeble hypnotic. ADALIN. — See Bromine Derivatives. BARBITAL AND BARBITAL DERIVATIVES.— See Barbital and Barbital Compounds. UREA. — Urea. — CO(NH2)2. — The diamide of carbonic acid. Actions and Uses. — Urea is an active diuretic: it is rapidly eliminated and is not poisonous. It is useless in the treatment of tuberculosis, and has no important solvent action on urinary calculi. It may be employed when diuresis is indicated, though it appears irrational in any renal disease characterized by reten- tion of nitrogen. Dosage. — From 0.5 to 4 Gm. (8 to 60 grains). Urea is given in solution, or it may be enclosed in cachets. Urea occurs as colorless, transparent prismatic crystals, almost odor- less and having a cooling saline taste. It is somewhat hygroscopic. It is soluble in water (1 in 1), more readily in hot water; soluble in alcohol (about 1 in 10) and (1 in 1) in boiling alcohol. It is insoluble in ether and chloroform; it fuses at 132 C, evolving ammonia and ammonium cyanate. Kept at 150 C, for some time, most of it is con- verted to biuret. If the temperature is raised to 170 C. the biuret evolves ammonia and is converted to cyanuric acid. Heated with water under pressure, it is decomposed into ammonium carbonate. It is not alkaline, but is a weak base and though a diamide, forms salts like a monacid base; these are acid to litmus. By hydrolysis it is converted into_ ammonia and carbon dioxide. Nitric and oxalic acids produce precipitates when added to concentrated solutions of urea. Urea-Merck. — A brand of urea-N. N. R, Merck & Co., Inc., Rahway. N. J., distributor. 446 NEW AND NONOFFICIAL REMEDIES VITAMINS AND VITAMIN PREPARATIONS FOR PROPHYLACTIC AND THERA- PEUTIC USE Vitamins The investigations of nutrition that have been initiated since the second decade of the present century have afforded an entirely new outlook upon many disorders, some of which have long been suspected to be of dietary origin. This is due to the scientific demonstration that in addition to the long recog- nized proximate principles — the proteins, carbohydrates and fats — which yield the energy requisite for life and activity and which, along with certain inorganic elements, form the struc- ture of the tissues and the fluids of the organism, other factors also are essential for the preservation of bodily well being and physiologic function. They are at present commonly designated as vitamins. The absence of any one of the vitamins from a diet which is satisfactory in other respects leads to the development of a typical syndrome which is called a "deficiency disease." These diseases may be as striking in their manifestations as are the direct result of underfeeding (caloric deficiency) or deprivation of essential inorganic elements such as iodine, iron, calcium or phosphorus. A striking illustration of a "deficiency disease" is presented by scurvy. This can be entirely averted or effectively cured by the inclusion of foods which contain vitamin C (Cevitamic acid) in the diet. It has been clearly established by convincing experiments that the prophylactic or remedial agent — the antiscorbutic substance — is a definite chemi- cal entity having the composition CeHsOe. The vitamin is present in many articles used as food, such as green vegetables and fruits, yet entirely lacking in others such as the common cereals and grains. Vitamin C is readily destroyed by heat under certain conditions, notably in an alkaline medium and in the presence of oxygen. However, foods can be processed without serious loss of vitamin C if precautions are taken to exclude air and if the reaction of the food is not unfavorable for the preservation of the vitamin. The foregoing illustration will suffice to indicate the charac- teristics of a vitamin — a substance essential for maintenance of normal metabolic functions, not identical with the more familiar nutrients, not synthesized in the human body, and therefore dependent on an exogenous supply, sometimes more labile than the foodstuffs proper and hence subject to deterioration, and distributed variously among the edible parts of animals and plants. The existence of four of the vitamins has been estab- lished by their isolation in pure chemical form, in fact the chemical constitution of three of them has been definitely estab- lished and one of them has been synthesized. VITAMIN PREPARATIONS 447 For convenience the designations, vitamins A, B, C and D, etc., have arisen. Scurvy, beriberi, rickets, pellagra, and xerophthalmia have been attributed with considerable experi- mental certainty to the lack of specific vitamins ; the protective or curative substances are accordingly sometimes spoken of as the antiscorbutic vitamin (C), the antirachitic vitamin (D), the antineuritic vitamin (Bi), the antipellagric vitamin (B2 or G), the antixerophthalmic vitamin (A), etc. Detailed accounts of the physiology of the vitamins can now be found in the newest textbooks on physiologic chemistry and nutrition. The problems raised thereby are the subject of active discussion and extensive investigation so that with respect to many features only tentative conclusions should be announced at this time. While some helpful chemical and physical methods for deter- mining the quantity of vitamins present in a given product are now available, for conclusive evidence we must rely on biologi- cal assays. To facilitate such assays and to make for uniform expression of vitamin content, the Health Organization of the League of Nations has sponsored the preparation and distribu- tion of standards for vitamins A, B, C and D. The Interna- tional Unit for each of the vitamins is defined in terms of the biological activity of a specific quantity of the respective stand- ard. The U. S. P. XI units for vitamins A and D are identical in value with the International units. While the requirements of the infant for vitamins A, B, C and D have been fairly well established, we have very little evidence that bears directly on the adult requirements for vita- mins A and D. Ordinarily there is no reason why a properly selected diet should not afiford an adequate supply of the requisite vitamins. Furthermore, with the exception of pellagra, there is no evidence of any noteworthy prevalence in this country of conditions in adults that might properly be ascribed to a lack of one or more vitamins. However, it must be admitted that under circumstances bringing about a highly restricted dietary regimen and leading to "one-sided" diets a relative shortage of some of the vitamins does at times arise. In almost all such instances the situation can be properly cor- rected by prescription of appropriate foods. Occasionally, and particularly with infants, a corrective result may be more effec- tively secured by the administration of products especially rich in the desired vitamin; for example, cod liver oil as a dietary adjunct in the prevention or teatment of rickets, and orange juice in the relief of scurvy. The clear indications for such specific vitamin therapy are still few in number. The chief justification for the recognition of special vitamin-bearing products at present applies to unusual concentrations of the desired potent principle that they may represent or to exceptionally desirable dosage forms. These considerations, which may be modified by the progress of research, have served as criteria in the selection of products offered for inclusion in N. N. R. as products rich in specific vitamins at present recognized to have demonstrable value in 448 NEW AND NONOFFICIAL REMEDIES clinical practice or human nutrition ; or as pure substances such as, carotene, which is a precursor of vitamin A, or cevitamic acid (crystalline vitamin C). Vitamin A The term "vitamin A" has been applied to any one of several substances or to a mixture of them producing a certain demon- strable specific physiologic effect. It seems to have been defi- nitely established that there are at least five substances which can produce to some degree this characteristic response in the animal body. These are vitamin A itself, alpha, beta and gamma carotene and cryptoxanthin. The last four of these, the precursors of vitamin A, are produced in the plant kingdom, and ingestion of these substances by most animals results in varying degree (depending on the species of animal and the precursor fed) in the formation of a compound having the empiric formula C20H29OH and to which no other name than vitamin A has been ascribed. The extent to which the different precursors of vitamin A can be converted to vitamin A by different species of animals has not definitely been established. The exact function of vitamin A has not been established, but the pathologic picture which results from varying degrees of deficiency has been the subject of extensive investigation. The claims recognized under vitamin A shall be recognized under the precursors of vitamin A only under conditions specified elsewhere under the heading of Carotene (p. 445). AUoivahle Claims. — 1. Evidence for the existence of vitamin A and its role in human nutrition is based on the fact that a characteristic eye disease, usually called xeroph- thalmia, results from a deficiency of this vitamin. 2. It is generally agreed that the first symptom or at least one of the first clinical symptoms of vitamin A deficiency is night-blindness, or nyctalopia. For this type of night blindness vitamin A is a specific. Cases of nyctalopia exist which do not respond to treatment with vitamin A, These may be due to congenital defects or to other diseases than avitaminosis "A." 3. Present indications are that vitamin A is an aid toward the establishing of resistance of the body to infections in general only when there has been an exhaustion of body reserves of the vitamin and the ingestion of vitamin A is inadequate. It certainly has not been shown to be specific in the prevention of colds, influenza and such infections, nor has it been demonstrated that ingestion of vitamin A far in excess of that necessary for normal body function and readily obtained from a properly selected diet is an aid in preventing various types of infections. 4. A deficiency of vitamin A results in a retardation of growth when body stores of the vitamin have been depleted, but it must be borne in mind that vitamin A is no more important in contributing to normal growth than any one VITAMIN PREPARATIONS 449 of the other vitamins, the essential mineral elements, or amino acids. Statements conveying the impression that vitamin A is more important in promoting growth than other food essentials are therefore considered misleading and objectionable. 5. There is at the present time inadequate evidence to warrant the claim that the ingestion of sufficient vitamin A will prevent the formation of renal calculi in man. Vitamin B The term "vitamin B" should not be used loosely. Ample evidence indicates that two or more physiologically active substances play a role in relation to numerous phenomena formerly explained in terms of vitamin B alone. At least two substances have received general recognition in this connection ; the existence of others has been reported but the evidence sub- mitted has not been accepted as convincing by all investigators in this field. The dififerences between the various products referred to is now substantiated by chemical evidences. Thus the crystallized antineuritic vitamin of Jansen and Donath, and of at least four other investigators, is a nitrogenous compound of defined composition; the so-called vitamin G appears to belong to the flavin group of compounds that have been exten- sively studied by Kuhn and others. There is no satisfactory evidence that the flavins have any definite relationship to the development or cure of pellagra. It seems desirable, therefore, to insist that claims shall refer clearly to one or more of the following : (a) Vitamin Bi, and/or (b) Vitamin G (B2), and/or (c) The undifferentiated mixture of these present in many foods, which might be referred to as "vitamin B complex" or "undifferen- tiated vitamin B." (d) Reference to "Pellagra-preventing value" shall be limited to products which have actually been tested for such value and shall not be based on so-called vitamin G assays with rats. It shall be understood that the terms in (c) above refer not only to vitamins B (Bi) and G (B2) but also to other alleged members of the vitamin B complex. If some other alleged member of the complex is being referred to, the statement might be allowed provided the investigator, who has alleged the exis- tence of the new factor, is cited. Allowable Claims. — 1. Vitamin Bx may he cited as of value in correcting and preventing anorexia of dietary origin in certain cases. There are many causes of anorexia, some referable to infections and the reactions thereto, others to organic dis- orders, and still others related to faulty diet. Where there is no rather obvious cause of anorexia in question, other than a possible dietary one, it is permissible to claim that vitamin Bi may be of therapeutic value when the condition to be treated is due to a deficiency of that vitamin. 450 NEW AND NONOFFICIAL REMEDIES 2. Vitamin Bx is of value in securing optimal grozvth of infants and children. Citations in the literature support the claim that a sub- optimal supply of vitamin Bi results in limitation of growth. 3. Vitamin Bi is of value in correcting and preventing beriberi. The consensus of the students of beriberi is that this disease is due primarily to an insufficient supply of vitamin B], There are conditions which probably could be desig- nated as "latent beriberi" ; it does not seem wise at this time to attempt the formulation of a definite statement covering such conditions other than that presented in Item 7. 4. Because vitamin Bx is a dietary essential its adminis- tration in concentrated form is of value in some conditions where difficulty in utilizing ordinary foods in the usual ivay is encountered. The present status of research on the clinical use of vitamin Bi for specific diseases other than beriberi and for infant feeding, is such that definite claims for therapeutic value in relation to such diseases cannot be recognized. Its use may be indicated, however, in such restricted conditions as pernicious vomiting of pregnancy, tube feedings through a jejunal fistula, and the like, because the above permitted statement applies to such conditions and gives an intelligent basis for such therapy. 5. Claims for concentrates of vitamin Bi, offered for clinical use should state the potency in terms of the International unit. The term "concentrate" or a synonym will not be recognized if the product does not exceed a potency of 25 International units per gram (or per cubic centimeter), or if it is a natural product which may have been subjected to a process of dehydration. 6. In connection with medicinal foods acceptable for N. N. R., the claim that a food is valuable because of its vitamin Bi content may be made only if it provides in the quantity of food consumed daily at least 200 units of vitamin Bi. Any food preparation having less than such an amount cannot be regarded as a noteworthy medicinal source of the vitamin. In the light of present knowledge the daily requirement for vitamin Bi appears to be not less than 50 units (International) for the infant and 200 units (Inter- national) for the adult. 7. There are many experimental indications in the litera- ture indicating other possible functions of vitamin Bi, e. g., an influence on intestinal motility and neuritis of various types, and also indications of greatly augmented require- ments when metabolism is increased as in hyperthyroidism, neuritis of various types, infections, etc. It seems too early to permit advertising claims for these conditions. VITAMIN PREPARATIONS 451 Vitamin C Cevitamic Acid There is ample experimental and clinical evidence to show that vitamin C in optimum amounts is an essential dietary con- stituent. Suboptimal amounts result in the development of clinical and pathologic phenomena to which the descriptive term scurvy has been applied. The chemical nature of the formerly unidentified essential food substance has been discovered. Its empirical formula is CeHsOe. Vitamin C has been prepared in commercial quantities both from natural sources and through synthesis. The Council on Pharmacy and Chemistry of the American Medical Associa- tion has adopted the nonproprietary designation cevitamic acid for the crystalline vitamin C introduced as Ascorbic Acid. Allozvable Claims. — 1. Definite claims for the therapeutic value of vitamin C should be permitted only in relation to scurvy until further clinical or experimental evidence has substantiated its usefulness in other states. 2. Vitamin C is acceptable for the correction and pre- vention of scurvy. This effect has been established experi- mentally and by clinical investigation. 3. It may be permissible under certain conditions to refer to the therapeutic value of vitamin C in early and latent scurvy. Convincing clinical evidence has established that this state does occur. It would be well to emphasize the fact that the diagnosis rests, however, on the basis of roent- genologic evidences in the long bones, and possibly failure to excrete an optimum amount of cevitamic acid in the urine. 4. Dental caries, pyorrhea, certain gum infections, ano- rexia, anemia, undernutrition and infection alone are not in themselves sufficient indications of vitamin C deficiency but according to experimental and clinical investigation they may be concomitant signs of vitamin C deficiency. Therefore, it would be permissible to accept the claim for the therapeutic value of vitamin C in these symptomatic conditions only zvhen it is definitely stated that they are the consequences of a deficiency or suboptimal amount of vitamin C or when there is a pathologic interference with assimilation of the amount necessary for the preservation of health. 5. Unless more convincing evidence is present than is now available, no claim referable to the anti-infective efifect of vitamin C will be recognized. Secondary infections are characteristic of disturbances of nutrition, particularly in all vitamin deficiency diseases. It has not been established that vitamin C has a therapeutic effect which directly influences associated secondary infections in scurvy. 6. Because vitamin C is a dietary essential its adminis- tration in concentrated form is of value in conditions where difficulty in introducing orally or utilizing ordinary foods 452 NEW AND NONOFFICIAL REMEDIES in the usual way is encountered. Vitamin C (cevitamic acid) is accepted as an essential dietary constituent in infant feeding but it should not be accepted for use in the treatment of diseases except according to the conditions mentioned above. It is generally administered in the form of a vitamin C carrying juice. When there is persistent vomiting, diarrhea, or any other condition preventing its utilization in proper amounts it would be permissible to give vitamin C parenterally in concentrated form as sodium cevitamate. 7. Concentrates of vitamin C offered for clinical use must state the potency in terms of the International unit. The International unit for vitamin C, which was formerly defined as the vitamin C activity of 0.1 cc. of lemon juice, has now been defined as the vitamin C activity of 0.05 mg. of 1 -cevitamic acid (ascorbic acid). This is the quantity of 1 -cevitamic acid usually found in 0.1 cc. of lemon juice. 8. The claim that a food is valuable because of its vitamin C content should be permitted only if it provides a daily intake of at least 250 units of vitamin C. 9. A reasonable general statement regarding allowable claims for vitamin C would be as follows : An optimum amount of vitamin C should be supplied at all ages for its therapeutic value in preventing the develop- ment of acute or latent scurvy. Claims for the therapeutic value of vitamin C may be accepted when the agent is described as a corrective mea- sure for scurvy due to a demonstrable absence or a sub- optimal quantity in the diet, or in cases in which it is definitely known that there is interference with the absorp- tion of an optimal amount. Advertising of vitamin C for such symptoms as failure to gain in weight or stoppage of growth, anorexia, anemia, infections, symptoms referable to the central nervous system or hemorrhagic conditions cannot be accepted unless it is definitely stated that the symptoms are referable to a demon- strable deficiency of vitamin C. The cevitamic acid equivalent or potency in terms of International units should be stated in all dosage claims for vitamin C. Cevitamic acid (vitamin C) is easily decom- posed in presence of certain other substances ; therefore, care should be exercised against administering it (or orange juice) in mixtures, or by such procedure as to render it ineffective. Vitamin D The term "vitamin D" is applied to one or more substances which function in the proper utilization of calcium and phos- phorus. Vitamin D has been produced in crystalline form aj one of the products of ultraviolet irradiation of ergosterol and VITAMIN PREPARATIONS 453 shown to be a sterol having the formula C28H43OH. Naturally occurring vitamin D has not been isolated, but there is evidence suggesting that it may not be identical with the artificially produced substance, and that more than one natural compound may function as the vitamin. Alloivable Claims. — 1. Vitamin D is recognized as a specific in the treatment of infantile rickets, spasmophilia and osteomalacia, diseases which are manifestations of abnormal calcium and phosphorus metabolism. Vitamin D is valuable in the prevention as well as in the curative treatment of these diseases. Complications such as renal insufficiency or glandular malfunction may preclude normal response to vitamin D therapy. During acute infections, especially of the gastro-intestinal tract, vitamin D may prove ineffective because poorly absorbed. 2. Direct exposure of the skin to ultraviolet light from the sun or from artificial sources results in the formation of vitamin D within the organism but the Council cannot recognize statements or implications that vitamin D has all beneficial effects of exposure to sunshine. 3. There is clinical evidence to justify the statement that vitamin D plays an important role in tooth formation and maintenance of normal tooth structure, but there is no warrant for the claim that adequate vitamin D intake will insure normal tooth structure or that adequate vitamin D intake will prevent dental caries. 4. Animal experimentation has shown that correction of an inadequate intake of vitamin D results in the more eco- nomical utilization of calcium and phosphorus and also that the undesirable effects of improper ratios of calcium and phosphorus in the diet can largely be overcome by normal intake of vitamin D. The importance of these observations in their application to man is not entirely apparent because of the lack of adequate clinical evidence showing the avail- ability of different forms of calcium and phosphorus, but it may be stated that vitamin D has a favorable influence on calcium and phosphorus metabolism. 5. The vitamin D requirement is greatest during the period of infancy. Beyond the age of infancy the exact vitamin D requirement of man under any specified conditions is not known but it appears that the requirement during pregnancy and lactation is increased. CAROTENE (Pro- Vitamin A) Carotene is a hydrocarbon having the empiric formula C40H58 which occurs in three isomeric forms referred to respectively as alpha, beta and gamma carotene. The alpha form is opti- cally active and the others are not. The beta form appears to predominate in nature, and the gamma is found in the 454 NEW AND NONOFFICIAL REMEDIES smallest quantities, but usually a mixture of the different forms occurs. The crystals are readily oxidized. They should be kept in a vacuum or in an inert gas in the dark at a low temperature. The International unit for vitamin A adopted at the Second International Conference on Vitamin Standardi- zation, 1934, is defined as the vitamin A activity of 0.6 micro- gram of beta carotene. There is considerable scientific evi- dence indicating that alpha and gamma carotene have one-half the vitamin A activity of beta carotene. The Council has reached the following decision with respect to the use of the term "Pro-vitamin A as a synonym for carotene: (1) that the term "A Pro-vitamin A" be regarded as a synonym for alpha, beta or gamma carotene or for cryptoxanthin and that the synonym "Pro-vitamin A" be adopted and used in New and Nonofficial Remedies for any combination for two or more of these, and (2) that when this synonym is used on the label of any accepted product, it appear in brackets after the Council name wath a statement of the vitamin A potency of the product. Actions and Uses. — It appears that at least a portion of the carotene ingested is converted in the liver into vitamin A. Carotene therefore has actions similar to those of vitamin A. As carotene may be a mixture of the alpha, beta and gamma forms, its relative efficiency may vary according to the ratio of these components. Evidence is not available on which to base the exact conversion factor of carotene in terms of clinical vitamin A effect. Much depends on the conditions for absorp- tion of pigment. In view of the fact that cases of carotenemia have arisen from overdosage, the Council warns against the administration of too large doses of carotene. The vitamin potencies stated are on the basis of biological assays and not on physical and chemical measurements establishing the iden- tity and purity of the product. Carotene-SMACO.— A brand of Carotene-N. N. R., obtained from carrots. Actions and Uses: — See preceding article. Carotene. Dosage. — The dosage of carotene or of vitamin A is not yet on a satisfactory basis. Based on the average daily dose of Cod Liver Oil-tJ. S. P. (three teaspoonfuls, 12 cc), the dose should be equivalent to at least 6,600 U. S. P. units of vitamin A, Carotene is generally administered in the form of carotene dissolved in an oily solution. Manufactured by the S. M. A. Corporation, Cleveland, Ohio. No U. S. patent or trademark. Carotene-SMACO occurs as crystals which in plain light show cleav- age in two directions and which are pleochroic-light yellow orange to dark yellow orange to dark orange. _ In polarized light they are anisotropic, biaxial with parallel extinction and medium low bire- fringence. The crystals are almost tasteless and have a slight aromatic odor. They are soluble in chloroform and benzene, slightly soluble in ether, petroleum ether, fats, and oils, very slightly soluble in alcohol, practically insoluble in water. (Carotene-SMACO as marketed is not completely soluble in petroleum ether.) Carotene-SMACO melts between 172 and 178 C. VITAMIN PREPARATIONS 455 Dissolve about 0.025 Gm. of carotene-SMACO in 50 cc. of chloro- form; mix 1 cc. of this solution with 5 cc. of a saturated solution of antimony trichloride in chloroform: a blue color develops in five min- utes. Dissolve exactly 0.020 Gm. of carotene-SMACO in 2 cc. of chloroform; dilute to exactly 100 cc, with petroleum ether; dilute 1 cc. of this solution to exactly 100 cc, with ethyl alcohol; measure the per cent transmittance of a 3 cm, layer of this solution at the following wave lengths: 490, 500, 515 and SSOfiii, the per cent transmittance values are within the following limits: 490/i/a, 12-17 per cent; SOOiM/i, 33-38 per cent; SlSfi/i, 75-81 per cent; 530/i/4, 90-95 per cent. Fuse about 0,1 Gm, of carotene-SMACO with metallic sodium, care- fully add the fused residue to a beaker containing water, boil, filter, add 3 cc. of ferrous sulfate solution, boil, add 1 cc. of ferric chloride solution, neutralize the alkali with diluted hydrochloric acid, filter: no blue precipitate remains on the filter paper (nitrogenous compounds). Dry 0.1 Gm. of carotene-SMACO to constant weight over phosphorus pentoxide: the loss is not more th.>n 0.2 per cent. Determine carbon and hydrogen by micro methods; .Sased on the dried material, the carbon is not less than 88.80 per cent nor more than 89.60 per cent, and the hydrogen is not less than JO 30 per cent nor more than 10.80 per cent. Incinerate about 0.10 Gm, of ca -otene-SMACO in a platinum dish: the residue is negligible. The following colorimetric assay is a modification of Palmer's method: Carotene in petroleum ether is matched against 0.2 per cent aqueous potassium dichromate solution. By this method 40 mm. of 0.2 per cent potassium dichromate solution is equivalent to 48 mm. of 0.00268 per cent carotene solution. Transfer about 0.020 Gm, of carotene to a 500 cc, flask, dissolve the crystals in about 2 cc. of chloroform, dilute with petroleum ether to exactly 500 cc, and match this in a colorimeter with 40 mm. of a 0.2 per cent aqueous potassium dichromate solution. Rapidly make five readings that do not vary more than 1.5 mm. Use the average reading in the following formula and calculate the per cent of carotene: 0.1287 X 500 , , ^-j ;— = per cent carotene: average weight of sample The amount of carotene in carotene-SMACO is not less than 92 per SMACO Carotene in Oil. — A solution containing 0.3 per cent of carotene-SMACO in cottonseed oil. It is biologically assayed to have in each gram a vitamin A potency of not less than 7,500 units, U. S, P. Actions and Uses. — The same as those of carotene-SMACO, Dosage. — See under Carotene-SMACO, The product as marketed is accompanied by a dropper designed to deliver 25 drops to the cubic centimeter. Manufactured by the S. M, A, Corporation, Cleveland, Ohio, SMACO carotene in oil is prepared by dissolving in cottonseed oil carotene-SMACO with an extract of carrots. The solution is standard- ized to 0.3 per cent of carotene-SMACO by the method described under that product. When assayed for vitamin A potency by the method of the U, S, P, it is required to contain not less than 7,500 units per gram. SMACO Carotene with Vitamin D Concentrate in Oil. — A solution in cottonseed oil of carotene-SMACO 0,3 per cent with sufficient vitamin D concentrate to bring the assayed potency to not less than 1,000 U, S, P. units per gram. When assayed for vitamin A potency by the method of the U, S, P, it is required to contain in each gram not less than 7,500 units. 456 NEW AND NONOFFICIAL REMEDIES Actions and Uses. — SMACO carotene with vitamin D con- centrate in oils is proposed as a substitute for a cod liver oil of equivalent potency. Dosage. — The same as for cod liver oil of equivalent potency. Manufactured by the S, M. A. Corporation. The vitamin D concen- trate is used by license of Columbia University under U. S. patent 1,678,454 (July 24, 1928; expires 1945). No U. S. trademark. SMACO Carotene and Vitamin D Concentrate in Cod Liver Oil. — A solution of carotene-SMACO, 0.03 per cent, in cod liver oil, adjusted by the addition of sufficient SMACO vitamin D concentrate so that it will assay at not less than 100 units of vitamin D (U. S. P.) per gram. The mixture is assayed to have a vitamin A potency of not less than 2,000 units U. S. P. per gram. The Carotene-SMACO is the source of not less than 650 of these units. Actions and Uses. — SMACO carotene and vitamin D concen- trate in cod liver oil is proposed for use as a substitute for cod liver oil of high potency. Dosage. — The same as for cod liver oil of equivalent potency. Manufactured by the S. M. A. Corporation, Cleveland. The vitamin D concentrate is used by license of Columbia University under U. S. patent 1,678,454 (July 24, 1928; expires 1945). No U. S. Trademark. CEVITAMIC ACID Crystalline vitamin C, /a^2/o-CH20H(CHOH)OCHCOH : COHCO (introduced as ascorbic acid). — Cevitamic acid may be prepared from adrenal glands, citrus fruits, cabbage, paprika and other plant materials. It may also be prepared synthetically. It oxidizes on exposure to air and light and should be preserved in an oxygen-free atmosphere protected from light. Actions and Uses. — Cevitamic acid is indicated for prophy- laxis and treatment of scurvy. Its use in caries, and in other conditions in which a deficiency of vitamin C may be a con- tributing factor, is not established. Dosage. — As a protective dose in infants, 0.01 Gm. (Yq grain), corresponding to from 15 to 30 cc. of fresh orange juice; the dosage for use in treatment has not been established. The therapeutic dose for infants is probably about 10 to 50 mg. and for adults probably about 100 mg. Cevitamic acid occurs as white or yellowish white, odorless, mono- clinic crystals, often tabular — a few showing simple twinning. The optical properties are as follows: biaxial; negative; weakly pleo- chroic; birefringence — strong (0.239); optic angle (2 E) about 5 degrees; extinction generally parallel but in some sections inclined about 12 degrees; indexes of refraction: a = 1.466 ± 0.002, )3 = 1.680 ± 0.002, 7 = 1.705 ± 0.002. It is freely soluble in water, soluble in alcohol and insoluble in chloroform and ether. It melts between 189 and 192 C. The rotation [a] 25/D of cevitamic acid determined in a solution containing the equivalent of 10 Gm. in 100 cc. of the solution falls between -f 20.5 and -f- 21.5. VITAMIN PREPARATIONS 457 To 1 cc. of a 2 per cent aqueous solution of cevitamic acid add 2 drops of sodium nitroprusside solution and make alkaline with tenth- normal sodium hydroxide solution: a blue color is produced that changes to green and then to red. Add 2 cc. of 2 per cent aqueous solution of cevitamic acid to 5 cc. of Fehling's solution: the Fehling's solution is slowly reduced in the cold. Transfer about 0.1 Gm. of cevitamic acid, accurately weighed, to a beaker containing 100 cc. of cooled distilled water that has just pre- viously been boiled, and 25 cc. of diluted sulfuric acid; titrate with tenth-normal iodine solution using starch as an indicator (1 cc. of tenth-normal iodine solution corresponds to 0.0088 Gm. of cevitamic* acid) : the iodine used corresponds to not less than 98 per cent cevitamic acid. Transfer about 0.12 Gm. of cevitamic acid, accurately weighed, to a beaker; add 20 cc. of water and tirate with tenth-normal sodium hydroxide using phenolphthalein as an indicator: the alkali used is equivalent to not less than 99.5 per cent nor more than 100.5 per cent cevitamic acid. Transfer about 0.1 Gm. of cevitamic acid, accurately weighed, to a wide-mouthed glass stoppered weighing bottle, dry in a vacuum over phosphorus pentoxide for eighteen hours: the loss is not greater than 0.3 per cent. Transfer about 0.1 Gm. of cevitamic acid to a platinum dish, ignite to constant weight: the ash is negligible. Cebione. — A brand of cevitamic acid-N. N. R., obtained from vegetable sources. Merck & Co.. Inc., New York, distributor. No U. S. patent. U. S. trademark 318,171. Ampules Cebione (Crystals), 0.1 Gm. Tablets Cebione (Crystals), 0.01 Gm. Tablets Cebione (Crystals), 0.05 Gm. FISH LIVER OILS, PREPARATIONS AND CONCENTRATES The chief fish Hver oil used therapeutically, and the only official one, is cod liver oil. Cod liver oil is now widely used as an adjunct in infant feeding. This oil is rich in both vita- mins A and D and is a readily digested fat. By virtue of its vitamin D content, cod liver oil has been demonstrated to have a favorable influence on the metabolism of calcium and phos- phorus in general and particularly in the prevention of rickets. In fact the usual recommended dosages of cod liver oil for infants are based on vitamin D requirements. The U. S. P. XI dose of cod liver oil for infants, 12 cc. daily, probably pro- vides more than three times as much vitamin A daily as an infant will obtain by breast feeding alone. The U. S. Pharmacopeia, besides giving tests for the purity of cod liver oil, also gives methods for the assay of its content of vitamin A and vitamin D ; furthermore, it pro- vides that the vitamin A potency and vitamin D potency of cod liver oil when designated shall be expressed in "United States Pharmacopeia units" per gram of oil and may be referred to as "U. S. P. units" per gram of oil. It is also stipulated that: The U. S. Pharmacopeia specifies that cod liver oil must contain in each gram at least 600 U. S. P. units of vita- min A and at least 85 U. S. P. units of vitamin D. Cod liver 458 NEW AND NONOFFICIAL REMEDIES oil may be flavored by the addition of not more than 1 per cent of any one or any mixture of flavoring substances recog- nized in this pharmacopeia. Evidence has accumulated to show that it is feasible to mar- ket cod liver oil having a vitamin A potency much higher than the lower limit of the pharmacopeial product. Accordingly, all brands in New and Nonofficial Remedies are required to have a vitamin potency of at least 850 vitamin A units per gram and at least 85 vitamin D units per gram when tested by the U. S. P. method. It has been shown that an effective concentrate of cod liver oil can be made and marketed. To be acceptable for inclusion in New and Nonofficial Remedies, such a concentrate should have a vitamin A potency of at least 14,000 U. S. P. units per gram, or 1,100 U. S. P. units per tablet or other dosage unit and a vitamin D potency of at least 1,400 U. S. P. units per gram, or 110 U. S. P. units per tablet or other dosage unit. The Council requires that the vitamin A and vitamin D potency of accepted brands of cod liver oil and cod liver oil concentrates be declared in U. S. P. units on the label of such products. Statements of the potency of tablet preparations of cod liver oil concentrate made on a "per tablet" basis and also on a "per gram of tablet" basis should appear in the firm's presentation and in New and Nonofficial Remedies. On the labels, however, a declaration of vitamin potency "per tablet" is sufficient. The U. S. P. recommended dosage is largely empiric, though corresponding to the widest general practice. The adult need of vitamin D (except in certain instances) ^ is problematic, and there is a lack of data on which to determine an adult dose of vitamin A. The Council believes that the U. S. P. dosage of cod liver oil is needlessly high and has fixed the dosage of cod liver oil for infants at 8 cc. (2 teaspoonfuls) daily. COD LIVER OIL.— "The partially destearinated fixed oil obtained from the fresh livers of Gadus Morrhua Linne and other species of the family Gadidae. Cod Liver Oil may he flavored by the addition of not more than 1 per cent of any one or any mixture of flavoring substances recognized in this U. S. Pharmacopeia. Cod Liver Oil contains in each Gm. at least 600 U. S. P. Units of Vitamin A and at least 85 U. S. P. Units of Vitamin D. "The Vitamin A potency and Vitamin D potency of Cod Liver Oil when designated shall be expressed in 'United States Pharmacopeia Units' per gram of oil and may be referred to as 'U. S. P.'" U. S. P. For standards see the U. S. Pharmacopeia under Oleum Alorrhuae. Actions and Uses. — See preceding article, Fish Liver Oils, Preparations and Concentrates. Dosage. — For infants, 8 cc. (2 teaspoonfuls) daily. VITAMIN PREPARATIONS 459 Abbott's A-B-D Malt Extract with Cod Liver Oil and ViosteroL— Malt extract, 57 per cent; cod liver oil with viosterol to adjust it to the antirachitic potency of the final product, 30 per cent (by volume); glycerin, 10 per cent; alcohol, 3 per cent. The finished mixture is assayed for vitamin Bi potency by a modification of the method of Sherman and Spohn (The Vitamins, Sherman and Smith, ed. 2, pp. 100, 102) and is required to contain not less than 60 units per fluidounce, the unit being that amount which fed to rats deprived of vitamin Bi (F) results in a total weight gain of 12 Gm. in twenty-eight days; it is assayed for vitamin Bj (G) by the method of Sherman (The Vitamins, Sherman and Smith, ed. 2, p. 135) modified by using Jansen and Donath's fullers' earth absorbate of Bi as a source of this vitamin in the vitamin Bs deficient diet, and is required to contain not less than 60 units per fluidounce, the unit being that amount which fed daily to rats deprived of vitamin B2 (G) results in a total weight gain of 12 Gm. in twenty- eight days. The vitamins A and D potencies of the finished product are: not less than 450 units CU. S. P.) of vitamin A per Gm., and 200 units (U. S. P.) of vitamin D per Gm. Dosage. — For infants, 2 cc. (30 minims) three times daily; for pre- mature and rapidly growing infants and for older children, 4 cc. (60 minims) three times daily; in severe rickets and for adults, 4 cc. (60 minims) or more four times daily. Manufactured by the Abbott Laboratories, North Chicago, 111. The viosterol used is manufactured by license of the Wisconsin Alumni Research Foundation under U. S. patent 1,680,818 (Aug. 14, 1928; expires 1945) and U. S. patent 1,871,136 (Aug. 9, 1932: expires 1949). Borcherdt's Malt Extract with Cod Liver Oil: Each 100 cc. contains cod liver oil, 25 cc, and Borcherdt's malt extract (plain) (essentially similar in extract of malt U. S. P.) 75 cc. The vitamin potency is: not less than 400 units (U. S. P. ) of vitamin A per Gm., 41 units (U. S. P.) of vitamin D per Gm., and one Sherman unit of vitamin B per Gm. (equivalent to 28.5 Sherman units per ounce). The vitamin A potency is calculated from protocols of assay according to the A. D. M. A. method, protocols of assay according to the new U. S. P. procedures not being available as the book went to press. Prepared by the Borcherdt Malt Extract Co., Chicago. No U. S. patent. U. S. trademarks 64,467 and 64,441. Maltine with Cod Liver OH: Maltine, 70 per cent, and cod liver oil, 30 per cent. Maltine is a preparation essentially similar to extract of malt-U. S. P., but it contains 1.9 per cent of alcohol and is prepared from malted barley, oats and wheat: as determined by a modification of the method of Chick and Roscce (Biochem. J. 21: 689, 1927), it contains one unit per Gm. (28 units per ounce) of vitamin Bi, one unit being the weight of this product necessary as the sole source of Bi in an otherwise adequate diet to protect growing rats from polyneuritis and to assure normal growth and Yz unit per Gm. (9 units per ounce) of vitamin Bo, one unit being the weight of the product necessary as the sole source of B2 in an otherwise adequate diet to protect growing rats from pellagra and to assure normal growth; 1 Gm. converts 5 to 7 Gm. of starch to maltose and dextrin in thirty minutes at from 40 to 42 C. The vitamins A and D potencies of the finished product are not less than 750 units (U. S. P.) of vitamin A per Gm., and not less than 110 units (U. S. P.) of vitamin D per Gm. Prepared by The Maltine Co., Brooklyn. No U. S. patent. U. S. trademark 44,566. Maltine with Cod Liver Oil and Iron Iodide: Maltine 70 per cent, cod liver oil 30 per cent, and ferrous iodide 0.44 Gm. per 100 cc. (2 grains to each fluidounce). Maltine is a preparation essentially similar to extract of malt U. S. P., but it contains 1.9 per cent of alcohol and is prepared from malted barley, oats and wheat; as determined by a modification of the method of Chick and Roscoe (^Biochem. J. 21: 689, 1927), it contains one unit per gram (28 units per ounce) of vitamin Bi, one unit being the weight of the product necessary as the sole source of Bi in an other- wise adequate diet to protect growing rats from polyneuritis and_ to assure normal growth; and J^ unit per gram (9 units per ounce) of vitamin B2, one unit being the weight of the product necessary as the sole source of B2 in an otherwise adequate diet to protect growing rats from pellagra and to assure normal growth; 1 Gm. converts 5 to 7 Gm. of starch to 460 NEW AND NONOFFICIAL REMEDIES maltose and dextrin in thirty minutes at from 40 to 42 C. The vitamins A and D potencies of the finished product are not less than 750 units (U. S. P.) of vitamin A per Gm., and not less than 110 units (U. S. P.) of vitamin D per Gm. Manufactured by the Maltine Company, Brooklyn. No U. S. patent. U. S. trademark 44,566. Abbott's Cod Liver Oil. — It has a vitamin A potency of not less than 1,500 units (U. S. P.) per gram and a vitamin D potency of not less than 100 units (U. S. P.) per Gm. Manufactured by the Abbott Laboratories, North Chicago, III. No U. S. patent or tradeniark. Abbott's cod liver oil complies with the U. S. P. standards for cod liver oil. In addition it is required to have a vitamin A potency of not less than 1,500 units per gram and a vitamin D potency of not less than 100 units per gram as described by the method of the U. S. P. Mead's Standardized Cod Liver Oil. — It has a potency of not less than 1800 units (U. S. P.) of vitamin A per gram and a vitamin D potency of not less than 175 units (U. S. P.) per gram. Manufactured by Mead Johnson and Co., Evansville, Ind. No U. S. patent or trademark. Mead's Standardized Cod Liver Oil Flavored. — Mead's Standardized cod liver oil, containing 0.12 per cent of a mixture of U. S'. P. essential oils of flavoring. Mead's Cod Liver Oil Fortified lifith Percomorph Liver Oil. — A mix- ture of cod liver oil-U. S. P. and percomorph liver oil 5 per cent. It has a potency of not less than 6,000 vitamin A units (U. S. P.) per gram and of not less than 850 vitamin D units (U. S. P.) per gram. Mead's Standardized cod liver oil complies with the U. S. P. standards for cod liver oil. In addition it is required to have a vitamin A potency of not less than 1,750 units per Gm. and a vitamin D potency of not less than 175 units per Gm. Nason's Palatable Cod Liver Oil. — Cod liver oil contain- ing 0.5 per cent of essential oils as flavoring, having a vitamin A potency as determined by the method of the U. S. Pharma- copeia of not less than 1750 units per Gm. and a vitamin D potency of not less than 130 units per Gm. Dosage. — For adults, 2 to 4 cc. (30 to 60 minims) three times a day; for children, 1 to 2 cc. (15 to 30 minims) three times a day. Manufactured by Tailby-Nason Co., Boston. No U. S. patent or trademark. Nason's palatable cod liver oil complies with the U. S. P. standard for cod liver oil. In addition, it is required to have a content of fat- soluble vitamin A, determined by the U. S. P. method, of not less than 1400 units per Gm., and an antirachitic potency of not less than 130 units per Gm. Parke, Davis & Company Standardized Cod Liver Oil. — It has a vitamin A potency of not less than 850 units (U. S. P.) per Gm. and a vitamin D potency of not less than 85 units (U. S. P.) per Gm. VITAMIN PREPARATIONS 461 Dosage.— Inianis, from 1 to 2 cc. (15 to 30 minims) ; older children, from 2 to 4 cc. (30 to 60 minims) ; adults, 4 cc. (1 fluidrachm) or more, three times a day. Manufactured by Parke, Davis & Co., Detroit. No U. S. patent or trademark. Malt Extract with Cod Liver Oil-P. D & Co.: Each 100 cc. contains standardized cod liver oil-P. D. & Co., 25 cc, and malt extract (unmedi- cated)-?, D. & Co., 75 cc, with chocolate and extract of vanilla as flavoring agents. Soluble Gelatin Capsules Parke, Davis & Company's Standardized Cod Liver Oil, 10 minims. Soluble Gelatin Capsules Parke, Davis & Company's Standardized Cod Liver Oil, 20 minims. Sohible Gelatin Capsules Parke, Davis & Company's Standardized Cod Liver Oil, 2.5 Gm. Soluble Gelatin Capsules Parke, Davis & Company's Standardized Cod Liver Oil, 5 Gm. Parke, Davis & Company's standardized cod liver oil complies with the standards of the U. S. Pharmacopeia. In addition, it is required to have a content of fat soluble vitamin A, determined by the method of the U. S. P. equivalent to not less than 850 units per Gm. Patch's Flavored Cod Liver Oil. — Cod liver oil contain- ing less than 0.5 per cent of essential oils as flavoring and having a vitamin A potency of not less than 1,500 vitamin A units (U. S. P.) per Gm., and a vitamin D potency of not less than 95 units (U. S. P.) per Gm. Dosage. — 4 cc. (1 fluidrachm) 3 times a day; children 2 cc. (30 minims) 3 times a day. Manufactured by The E. L. Patch Co., Boston. No U. S. patent or trademark. Patch's flavored cod liver oil complies with the U. S. P. standards for cod liver oil. In addition it is required to have a content of fat- soluble vitamin A of not less than 850 units per Gm. as determined by the method of the U. S. Pharmacopeia. Scott's Norwegian Cod Liver Oil (Plain).— It has a vitamin A potency of not less than 1,400 units (U. S. P.) per Gm., and a vitamin D potency of not less than 85 units (U. S. P.) per Gm. Adequate protocols of assay according to the U. S. P. procedure not having been available at the time the book went to press, the vitamin A potency is calculated from that previously found acceptable. Dosage. — For patients over 5 months of age 4 cc. (1 flui- drachm) three times daily. Manufactured by Scott & Bowne Laboratories, Bloomfield, N. J. No U. S. patent. U. S. trademark 17960. Scott's Norwegian Cod-Liver Oil (Flavored). — Scott's Norwegian cod- liver oil (plain), containing 0.78 per cent of a mixture of oils of pepper- mint, sweet birch, cassia and bitter almond as flavoring. Scott's Norwegian cod-liver oil (plain) complies with the U. S. P. standards for cod liver oil. In addition, it is required to have a content of fat-soluble vitamin A, determined by the U. S. P. method, of not less than 1,400 units per Gm. 462 NEW AND NONOFFICIAL REMEDIES Squibb Cod Liver Oil. — It has a vitamin A potency of not less than 2,100 units per gram and a vitamin D potency of not less than 350 units per gram when assayed by the method of the U. S. P. Dosage. — The average adult daily dose is 15 cc. (4 flui- drachms) ; for children, half this amount or less ; for infants, 0.5 to 2.0 cc. (8 to 30 minims) according to age. Manufactured by E. R, Squibb & Sons, New York. No U. S. patent or trademark. Squibb Cod-Halibut Liver Oil (see under Squibb Stabilized Halibut Liver Oil). Squibb Mint-Flavored Cod-Liver OH: Squibb cod liver oil contain- ing 0.67 per cent of oil of spearmint as flavoring. Squibb cod liver oil complies with the U. S. P. standard for cod liver oil. In addition it is required to have a content of fat soluble vitamin A, determined by the method of the U. S. P. of not less than 2,100 units per Gm. and an antirachitic potency of not less than 250 units per Gm. Ucoline Standardized Cod Liver Oil. — Cod liver oil con- taining 0.5 per cent of a mixture of equal parts of oil of peppermint and oil of wintergreen as flavoring, and having a vitamin A potency of not less than 1,400 units (U. S. P.) per gram and a vitamin D potency of not less than 102 units (U. S. P.) per Gm. The vitamin potencies are calculated from protocols of assay based on procedures other than the U. S. P. method, data according to the latter not being availa- ble when the book went to press. Dosage. — For adults, 2 to 4 cc. (30 to 60 minims) three times a day; for children, 1 to 2 cc. (15 to 30 minims) three times a day. Manufactured by the Ucoline Products Co., Chicago. No U. S. patent or trademark. Ucoline standardized cod liver oil is required to have a content of fat- soluble vitamin A as determined by the method of the U. S. P. of not less than 1,000 units per gram and an antirachitic potency, as determined by the method of the American _ Drug Manufacturers Asso- ciation, of not less than ZZZ vitamin D units per gram. COD LIVER OIL WITH VIOSTEROL.— Viosterol dissolved in cod liver oil, to adjust it to the potency of not less than 850 units (U. S. P.) of vitamin A per Gm., 360 units (U. S. P.) of vitamin D per Gm. Actions and Uses. — See general article, Viosterol. Cod liver oil with viosterol is proposed for use in conditions in which it is desired to supplement the administration of vitamin A with that of a relatively large amount of vitamin D. Dosage. — For infants and young children, 2.5 to 3.3 cc. (53 to 67 minims) daily; for adults and in severe cases doses up to 7 cc. (140 minims) or more are given. Cod liver oil with viosterol is prepared by addition of irradiated ergosterol to cod liver oil in such proportion that the finished product will have a potency of not less than 850 units (U. S. P.) of vitamin A per Gm. and not less than 360 units (U. S. P.) of vitamin D per Gm. VITAMIN PREPARATIONS 463 Abbott's Cod Liver Oil with Viosterol. — A brand of cod liver oil with viosterol-N. N. R. Manufactured by the Abbott Laboratories, North Chicago, under U. S. patent 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9, 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. Irradiated ergosterol, prepared by the method described under viosterol in oil-Abbott, is added to cod liver oil and the finished product is required to have a vitamin A potency of not less than 1,500 units (U. S. P.) per gram and not less than the vitamin D potency of cod liver oil with viosterol-N. N. R. Mead's Cod Liver Oil with Viosterol. — A brand of cod liver oil with viosterol-N. N. R. Manufactured by Mead Johnson & Co., Evansville, Ind., under U. S. patent 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9, 1934; expires, 1951) under license of the Wisconsin Alumni Research Foundation. Irradiated ergosterol, prepared by the method described under Mead[s viosterol in oil, is added to cod liver oil and the finished product is required to have a vitamin A potency of not less than 1750 units (U. S. P.) per gram and not less than the vitamin D potency of cod liver oil with viosterol-N. N. R. Parke, Davis & Company's Cod Liver Oil with Vios- terol. — A brand of cod liver oil with viosterol-N. N. R. Manufactured by Parke, Davis & Co., Detroit, under U. S. Patent 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9, 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. Viosterol, prepared by the method described under Parke, Davis & Co.'s viosterol in oil, is added to cod liver oil and the finished product is required to have a vitamin A potency of not less than 850 units (U. S. P.) per gram and to have not less than the vitamin D potency of cod liver oil with viosterol-N. N. R. Squibb Cod Liver Oil with Viosterol. — A brand of cod Hver oil with viosterol-N. N. R. Manufactured by E. R. Squibb & Sons, New York, under U. S. patent 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9, 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. Irradiated ergosterol, prepared by the method described under viosterol in oil, Squibb, is added to cod liver oil and the finished product is required to have a vitamin A potency of not less than 2,100 units (U. S. P.) per gram and not less than the vitamin D potency of cod liver oil with viosterol-N. N. R. Squibb Cod Liver Oil with Viosterol, Mint-Flavored. — A brand of cod liver oil with viosterol-N. N. R., containing 0.67 per cent of oil of spearmint as flavoring. Manufactured by E. R. Squibb & Sons, New York, under U. S. patent 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9, 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. _ Irradiated ergosterol, prepared by the method described under viosterol in oil-Squibb is added to cod liver oil containing 0.67 per cent of oil of spearmint as flavoring and the finished product is required to have a vitamin A potency of not less than 2,100 units (U. S. P.) per gram and not less than the vitamin D potency of cod liver oil with viosterol-N. N. R. 464 NEW AND NONOFFICIAL REMEDIES CLINADOL CO.'S COD LIVER OIL CONCEN- TRATE. — An extract of the nonsaponifiable fraction of cod liver oil in maize oil, to which has been added gluside (3 in 10,000) and oil of cassia 2 per cent. It has a vitamin potency of not less than 7,700 units (U. S. P.) of vitamin A per Gm. and not less than 386 units (U. S. P.) of vitamin D per Gm. Protocols of assay according to the new U. S. P. procedures not being available as the book went to press, these potencies are calculated from those previously found acceptable. Actions and Uses. — Clinadol Co.'s cod liver oil concentrate possesses properties similar to those of cod liver oil so far as these depend on the vitamin content of the latter. Dosage. — From 10 to 40 drops daily. A glass dropper is included with_ the market package, designed to deliver approxi- mately 1 minim per drop. Manufactured by the Clinadol Co., Inc., New York, N. Y. No U. S. patent. U. S. trademark 279,325. The vitamin A potency of Clinadol Co.'s cod liver oil concentrate is determined by the method of the U. S. Pharmacopeia; when assayed by this method it is required to have a vitamin potency of not less than 7,700 vitamin A units per Gm. and not less than 386 vitamin D units per Gm, COD LIVER OIL CONCENTRATE LIQUID (LEDERLE). — A concentrate of the unsaponifiable fraction of cod liver oil dissolved in sufficient cod liver oil to give the desired potency to the marketed product. It has a vitamin A potency of not less than 60,000 units (U. S. P.) per gram and a vitamin D potency of not less than 8,500 units (U. S. P.) per gram. Actions and Uses. — It possesses the therapeutic properties recognized for the vitamins present in cod liver oil. Dosage. — For the concentrate in vials, 9 drops (3 minims, 0.18 cc.) daily for infants (the vials are marketed with a dropper designed to dispense three drops to the minim) ; for the capsules, one to two daily for children, two to three daily for adults. Manufactured by the Lederle Laboratories, Inc., Pearl River, New York. No U. S. Patent or trademark. Cod Liver Oil Concentrate Liquid (Lederle), Vials, 5 cc. — Each minim (3 drops, 0.06 cc.) has a vitamin A potency of not less than 3,400 units (U. S. P.) and a vitamin D potency of not less than 484 units (U. S. P.). Cod Liver Oil Concentrate Liquid (Lederle) Capsules, 3 minims. — Each capsule has a vitamin A potency of not less than 10,260 units (U. S. P.), and a vitamin D potency of not less than 1,400 units (U. S. P.). KINNEY'S COD LIVER OIL CONCENTRATE LIQUID. — A concentrate of the unsaponifiable fraction of cod liver oil dissolved in sufficient cod liver oil to give the desired potency to the marketed product. It has a vitamin A potency of not less than 60,000 units (U. S. P.) per gram and a vita- min D potency of not less than 8,500 units (U. S. P.) per gram. VITAMIN PREPARATIONS 465 Actions and Uses. — It possesses the therapeutic properties attributed to the vitamins present in cod liver oil. Dosage. — For the Liquid: Infants, from six to eight drops daily; children, two to four drops three times daily; adults, four drops three times daily. The liquid is marketed with a dropper designed to supply 3^ minim (0.041 cc.) in each two drops. For the Capsules : Children, one capsule daily ; adults, one to two capsules daily. Manufactured by the Health Products Corporation, Newark, N. J. (Scientific Sugars Co., Indianapolis, distributor) U. S. patent 1,984,858. Kinney's Cod Liver Oil Concentrate Capsules, 3 minims. — Each capsule contains Kinney's Cod Liver Oil Concentrate Liquid, 3 minims, and has a vitamin A potency of not less than 10,000 units (U. S. P.) and a vitamin D potency of not less than 1,450 units (U. S. P.). Kinney's Cod Liver Oil Concentrate Liquid, Vials, 5 cc. — Each fS minim (0.038 Gm.) has a vitamin A potency of not less than 2,280 units (U. S. P.) and a vitamin D potency of not less than 320 units (U. S. P.). SMACO VITAMIN D CONCENTRATE IN OIL.— A solution in cottonseed oil of the vitamin D concentrate of cod liver oil obtained by the method of Zucker. It is assayed to have in each gram a potency of not less than 1,000 units of vitamin D (U. S. P;). ' Actions and Uses. — SMACO vitamin D concentrate in oil is proposed for use as an antirachitic. Dosage. — Based on the average daily dose of cod liver oil U. S. P. (three teaspoonfuls, 12 cc), the dose should be equiva- lent to at least 930 units of vitamin D, U. S. P. This is sug- gested as an approximate dosage. The product as marketed is accompanied by a dropper designed to deliver 25 drops to the cubic centimeter. Manufactured by S. M. A. Corporation, Cleveland. The vitamin D concentrate is used by license of Columbia University under U. S. patent 1,678,454 (July 24, 1928; expires 1945). No U. S. trademark. WHITE'S COD LIVER OIL CONCENTRATE (LIQUID). — A concentrate of the unsaponifiable fraction of cod liver oil dissolved in sufficient cod liver oil to give the desired potency to the finished product. It has a vitamin A potency of not less than 60,000 units (U. S. P.) per gram and a vitamin D potency of not less than 8,500 units (U. S. P.) per gram. Actions and Uses. — It possesses properties similar to those of cod liver oil so far as these depend on the vitamin content of the latter. Dosage. — For the Liquid: Infants, from six to eight drops daily ; children, two to four drops three times daily ; adults, four drops three times daily. The liquid is marketed with a dropper designed to supply ^3 minim (0.041 cc.) in each two 466 NEW AND NONOFFICIAL REMEDIES drops. For the Capsules : Children, one capsule daily ; adults, one to two capsules daily. Manufactured by the White Laboratories, Inc., Newark, N. J., U. S. patent 1,984,858. White's Cod Liver Oil Concentrate Capsules, 3 minims. — Each capsule contains White's Cod Liver Oil Concentrate (Liquid) 3 minims and has a vitamin A potency of not less than 10,260 units (U. S. P.} and a vitamin D potency of not less than 1,453 units (U. S. P.). White's Cod Liver Oil Concentrate Liquid, Vials, 50 cc. — Each ^ minim (0.038 Gm.) has a vitamin A potency of not less than 2,280 units (U. S. P.), and a vitamin D potency of not less than 320 units (U. S. P.). TABLETS COD LIVER OIL CONCENTRATE- LEDERLE. — A cod liver oil concentrate in the form of sugar-coated tablets, each having a vitamin potency of not less than 3,138 units (U. S. P.) of vitamin A, and not less than 314 units (U. S. P.) of vitamin D. Each gram of tablet has a vitamin potency of not less than 5,320 units (U. S. P.) of vitamin A, and not less than 532 units (U. S. P.) of vitamin D. Actions and Uses. — Tablets cod liver oil concentrate-Lederle possess properties similar to those of cod liver oil so far as these depend on the fat soluble vitamin content of the latter. Dosage. — The dosage should be regulated according to the needs of the individual patient. The usual dosage for adults is two to three tablets after meals ; for children, one to two tablets after meals. Manufactured by the Lederle Laboratories, Inc., Pearl River, New York. No U. S. patent or trademark. The basic concentrate is obtained from cod liver oil by concentration of the unsaponifiable fraction of the latter. The vitamins A and D potencies of tablets cod liver oil concentrate-Lederle are determined by the methods of the U. S. P.: When assayed by these methods the product is required to have a potency of not less than 3,138 vitamin A units per tablet, or 5,320 vitamin A units per Gm. of tablet and not less than 314 vitamin D units per tablet, or 532 vitamin D units per Gm. of tablet. Biologic assays are repeated on the finished tablet. UCOLINE COD LIVER OIL CONCENTRATE.— The unsaponifiable fraction of cod liver oil, prepared by the Marcus process, dissolved in a bland vegetable oil. Each gram of the solution has a vitamin potency of 7,700 units (U. S. P.) of vitamin A and 552 units (U. S. P.) of vitamin D. The potencies are calculated from protocols of assay based on pro- cedures other than the new U. S. P. method, data according to the latter not having been available when the book went to press. Actions and Uses. — Ucoline Cod Liver Oil Concentrate possesses properties similar to those of cod liver oil so far as these depend on the fat soluble vitamin content of the latter. Dosage. — From 3 to 6 drops of the concentrate solution three times daily (a glass dropper is included in the marketed package, VITAMIN PREPARATIONS 467 designed to deliver one minim per drop) ; for the tablets, 1 to 2, three times daily. Manufactured by the Ucoline Products Company, Chicago, under U. S. patent 1,690,091 (Oct. 30, 1928, expires 1945). No U. S. trademark. Ucoline Cod Liver Oil Concentrate Tablets. — Each sugar coated tablet contains 0.02 Gm. of the dry concentrate. They are assayed to contain in each tablet not less than 1,400 units (U. S. P.) of vitamin A and nov less than 154 units (U. S. P.) of vitamin D. This represents 2,506 units (U. S. P.) of vitamin A, and 274 units (U. S. P.) of vitamin D per gram of tablet. These potencies are calculated from protocols of assay based on procedures other than the new U. S. P. method, data according to the latter not having been available when the book went to press. WHITE'S COD LIVER OIL CONCENTRATE TABLETS. — A cod liver oil concentrate in the form of tablets. Each tablet has a vitamin A potency of not less than 3,138 units and a vitamin D potency of not less than 314 units when assayed by the method of the U. S. P. ; this represents a potency per gram of tablet of 6,276 units of vitamin A and 628 units of vitamin D, U. S. P. Actions and Uses. — White's cod liver oil concentrate tablets possess properties similar to those of cod liver oil so far as these depend on the fat-soluble vitamin content of the latter. Dosage. — For adults, two tablets three times daily ; for chil- dren, one tablet three times daily, after each meal; for infants, one tablet daily, crushed and dissolved in the feeding. Manufactured by White Laboratories, Inc., Newark, N. J. U. S. patent 1.984,858. IV kite's Cod Liver Oil Concentrate Liquid, Vials, 5 cc. — Each two- thirds minim (0.038 Gni.) has a vitamin A potency of not less than z,280 units (U. S. P.), and a vitamin D potency of not less than 320 units (U. S. P.). The concentrate employed in the manufacture of White's cod liver oil concentrate tablets is obtained from cod liver oil by concentration of its unsaponifiable fraction. The vitamins A and D potencies of White's cod liver oil concentrate tablets are determined by the U. S. P. method; when assayed by this method the product is required to have a potency of not less than 3,138 vitamin A units per tablet, or 6,276 vitamin A units per Gm. of tablet, and 314 units of vitamin D per tablet, or 628 vitamin D units per Gm. of tablet. HALIBUT LIVER OIL.— Oleum Hippoglossi. — A fixed oil obtained from the fresh livers of Hippoglossns liippo- glossus. It is biologically assayed to have a potency of not less than 44,800 units of vitamin A (U. S. P.) per gram and not less than 540 units of vitamin D (U. S. P.) per gram. Actions and Uses. — The same as those for cod liver oil (See General Article, Fish Liver Oils, Preparations and Concentrates). Dosage. — For infants, 6 to 10 drops (2.5 to 3.5 minims) daily; for premature and rapidly growing infants, 15 drops (5.25 minims) daily. For severe vitamin deficiencies, 20 drops (7 minims) or more may be given at the discretion of the 468 NEW AND NONOFFICIAL REMEDIES physician. The accepted preparations are marketed with an accompanying dropper designed to deliver a certain number of drops to the minim. Halibut liver oil is a yellow to brownish yellow, oily liquid. It has a slightly fishy but not rancid odor and a fishy taste. Halibut liver oil is slightly soluble in alcohol but is soluble in ether, chloro- form, benzene, carbon disulfide and ethyl acetate. The specific gravity is from 0.920 to 0.930 at 25 C. The refractive index is from 1.480 to 1.485 at 20 C. A solution of 1 drop of the oil in 1 cc. of chloroform when shaken with 1 drop of sulfuric acid acquires a blue color, changing to violet, dark green and finally brown. Treat 5 cc. of oil with 5 cc. of benzene and centrifuge for twenty-five minutes at 25 C: no precipitate forms and a clear solution remains. Dissolve 2 Gni. of halibut liver oil in 20 cc. of a mixture of equal volumes of alcohol and ether, which previously has been neutralized with tenth-normal sodium hydroxide, using 5 drops of phenolphthalein T. S. as indicator, and titrate with tenth-normal sodium hydroxide to the production of a pink color which persists for fifteen seconds: not more than 1 cc. of tenth-normal sodium hydroxide is required {free acid). The amount of unsaponifiable matter, as determined by the method of U. S. P. X, page 463, is not less than 7 per cent nor more than 13.5 per cent (it is solid in appearance). The saponification value as determined by the method of U. S. P. X, page 457, is not less than 160 and not more than 180. The iodine value, as deter- mined by the method of U. S. P. X, page 445, on 0.18 to 0.20 Gm. of sample, accurately weighed, is not less than 125 and not more than 155. Abbott's Haliver Oil, Plain. — A brand of hahbut liver oil-N. N. R. Manufactured by the Abbott Laboratories, North Chicago, 111. U. S. patent and trademark applied for. Abbott's Haliver Oil Plain Capsules, 3 minims: Each capsule contains Abbott's haliver oil, plain, 3 minims. Abbott's haliver oil plain is prepared by extracting the oil of fresh halibut livers. The oil is refined and assayed biologically to have not less than the potency of halibut liver oil-N. N. R. I. V. C. Halibut Liver Oil, Plain.— A brand of halibut liver oil-N. N. R. Manufactured by International Vitamin Corporation. New York. No U. S. patent. U. S. trademark 314.818. Capsules I. V. C. Halibut Liver Oil, Plain, 3 mi7iims. — The content of each capsule is assayed to contain not less than 10,000 units (U. S. P.) of vitamin A and not less than 170 units (U. S. P.) of vitamin D. Manufactured by the International Vitamin Corporation, New York. No U. S. patent. U. S. trademark 314,818. McKesson's Halibut Liver Oil Plain, 11 cc. — A brand of halibut liver oil-N. N. R. Manufactured by the International Vitamin Corporation, New York (McKesson & Robbins, Inc., Bridgeport, Conn., distributor). No U. S. patent. McKesson's Halibut Liver Oil Plain, Capsules, 3 minims. — The content of each capsule is assayed to contain not less than 10,000 units (U. S. P.) of vitamin A and not less than 170 units (U. S. P.) of vitamin D. McKesson's halibut liver oil plain is prepared by extracting the oil of fresh halibut livers. The oil is refined and assayed to have not less than the potency of halibut liver oil-N. N. R. VITAMIN PREPARATIONS 469 McKesson's Halibut Liver Oil with Vitamin D Concentrate in Neutral Oil, Capsules, S minims. — The content of each capsule is assayed to con tain not less than 10,000 units (U. S. P.) of vitamin A and 945 units (U. S. P.) of vitamin D. Manufactured by the International Vitamin Corporation, New York (McKesson & Robhins, Inc., Bridgeport, Conn., distributor). No U. S. patent. Mead's Halibut Liver Oil.— A brand of halibut liver oil- N. N. R. Manufactured by Mead Johnson & Co., Evansville, Ind. No U. S. patent or trademark. Mead's halibut liver oil is prepared by warming the livers to coag- ulation; the extracted oil is filtered, treated with a dilution of alkali, and then washed, the entire process being conducted with a substantial exclusion of air. The refined oil is assayed biologically to have not less than the potency of halibut liver oil-N, N. R. Parke-Davis Haliver Oil, Plain. — A brand of halibut liver oil-N. N. R. Marketed by Parke, Davis & Company, Detroit. U. S. patent and trademark applied for. Soluble Gelatine Capsules Parke-Davis Haliver Oil, Plain, S minims: Each capsule contains Parke-Davis haliver oil, plain, 3 minims, with suf- ficient cod liver oil to fill the capsule. Parke-Davis haliver oil, plain, is prepared by extraction from the livers of the halibut. The oil is refined and assayed biologically to have not less than the vitamin potency of halibut liver-oil-N. N. R. Squibb Plain Halibut Liver Oil. — A brand of halibut liver oil-X. X. R. Manufactured by E. R. Squibb & Sons, New York. No U. S. patent or trademark. Soluble Gelatine Capsules Squibb Plain Halibut Liver Oil, 3 minims: Each capsule contains approximately 10 drops or 0.2 cc. of Squibb Plain Halibut Liver Oil. Squibb Cod-Halibut Liver OH: A blend of refined oils from the livers of the cod and halibut in such proportions that the finished product has a vitamin potency of not less than 4,200 vitamin A units (U. S. P.) per gram and 700 vitamin D units (U. S. P.) per gram. Squibb halibut-liver oil is prepared by extraction from the livers of the halibut. The oil is refined and assayed to have not less than the potency of halibut liver oil-N. N. R. HALIBUT LIVER OIL WITH VIOSTEROL.— Halibut liver oil to which has been added sufficient viosterol (irradiated ergosterol) to assure a potency of not less than 9,000 vitamin D units (U. S. P.) per gram ; the halibut liver oil used is adjusted (when necessary) to have a vitamin A potency of not less than 44,800 units (U. S. P.) of vitamin A per gram by the addition of fish liver oils from one or more of the species Gadiis morrhua, Ophiodon elongatus and Ano- plopoma fimbria. Actions and Uses. — The same as those for cod liver oil (See General Article, Fish Liver Oils, Preparations and Concen- trates, and General Article, Viosterol). 470 NEW AND NONOFFICIAL REMEDIES Dosage. — For infants, 8 to 10 drops (3 to 3.5 minims) daily; for premature and rapidly growing infants, 15 drops (5.25 minims) daily; for older children, 15 to 20 drops (5.25 to 7 minims) daily; for adults, especially nursing and expectant mothers, 20 drops (7 minims) or more daily. The marketed preparation is accompanied by a special dropper designed to deliver a certain number of drops to the minim. Abbott's Haliver Oil with Viosterol. — A brand of halibut liver oil with viosterol-N. N. R. Manufactured by the Abbott Laboratories, North Chicago, 111. U. S. patent and trademark applied for. The viosterol used is manufactured under U. S. patent 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9, 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. Soluble Gelatin Capsules Abbott's Haliver Oil with Viosterol, 3 minims: Each capsule contains 3 minims of Abbott's halibut liver oil with viosterol diluted with 3 minims of other fish oils. Abbott's haliver oil with viosterol is prepared by combining halibut liver oil, one or more other fish liver oils, and viosterol in such pro- portions that the finished product will have not less than the potency of halibut liver oil with viosterol-N. N. R. Mead's Viosterol in Halibut Liver Oil. — A brand of halibut liver oil with viosterol-N. N. R. Manufactured by Mead Johnson & Co., Evansville, Ind. No U. S. patent or trademark. The viosterol used is manufactured under U. S. patent 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9. 1932; expires 1949) under license of the Wisconsin Alumni Research Foundation. Mead's Viosterol in Halibut Liver Oil (In Capsules) : Each capsule contains 3 minims of Mead's viosterol in halibut liver oil. Mead's Viosterol in halibut liver oil is prepared by combining refined halibut liver oil, one or more other fish liver oils, and viosterol in such proportions as to bring the vitamin potency of the finished product to not less than that of halibut liver oil in viosterol-N. N. R. Parke-Davis Haliver Oil with Viosterol. — A brand of halibut liver oil with viosterol-N. N. R. Manufactured by Parke, Davis & Company, Detroit. U. S. patent and trademark applied for. The viosterol used is manufactured under U. S. patent 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9, 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. Soluble Gelatin Capsules Haliver Oil with Viosterol. Parke-Davis haliver oil with viosterol is prepared by combining halibut liver oil, one or more other fish liver oils, and viosterol in such proportions that the finished product will have not less than the vitamins A and D potency of halibut liver oil with viosterol-N. N. R. Squibb Halibut Liver Oil with Viosterol. — A brand of halibut liver oil with viosterol-N. N. R. Manufactured by E. R. Squibb & Sons, New York. No U. S. patent or trademark. The viosterol used is manufactured under U. S. patents 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9, 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. VITAMIN PREPARATIONS 471 Soluble Gelatine Capsules Squibb Halibut Liver Oil with Viosterol, 3 minims: Each capsule contains approximately 10 drops or 0.2 cc. of Squibb Halibut Liver Oil with Viosterol. Squibb halibut-liver oil with viosterol is prepared by combining hali- but liver oil with viosterol in oil in such proportions that the finished product will have not less than the potency of halibut liver oil with viosterol-N. N. R. I. V. C. HALIBUT LIVER OIL WITH VITAMIN D CONCENTRATE IN NEUTRAL OIL.— Halibut liver oil to which has been added a concentrate of liver oils of Gadus morrhua, Ophiodon elongatiis and Anoplopoma fimbria. It is assayed to have a potency of not less than 59,000 units (U. S. P.) of vitamin A per gram and not less than 1,000 units (U. S. P.) of vitamin D per gram. Manufactured by the International Vitamin Corporation, New York. The vitamin D concentrate used is made under U. S. patent 1,690,091. U, S. trademark 314,818. Capsules I. V. C. Halibut Liver Oil zvith Vitamin D Concentrate in Neutral Oil, 3 minims. — The content of each capsule is assayed to con- tain not less than 10,000 units (U. S. P.) of vitamin A and not less than 945 units (U. S. P.) of vitamin D. McKESSON'S HALIBUT LIVER OIL WITH VITAMIN D CONCENTRATE IN NEUTRAL OIL, 6 CC. — Halibut liver oil with added natural vitamin D obtained from cod liver oil and other fish liver oils. It is assayed to have a potency of not less than 59,000 units (U. S. P.) of vita- min A per gram and not less than 1,000 units (U. S. P.) of vitamin D per gram. Manufactured by the International Vitamin Corporation, New York (McKesson & Robbins, Inc., Bridgeport, Conn., distributor). The vitamin D concentrate used is made under U. S. patent No. 1,690,091. PERCOMORPH LIVER OIL.— Oleum Percomor- phum. — A mixture containing the fixed oils obtained from the fresh livers of the percomorph fishes, principally Xiphias gladius, Pneumatophorus diego, Thunnus thynnus and Stereolepis gigas — sometimes also Neothunnus macropterus, Katsuwonus pelamis, Sarda chiliensis, Germo alalunga, Thunnus orientalis, Scomber scombrus, Seriola dorsalis, Lutianus campechanus, Epinephelus morio, Roccus lineatus, Cynoscion nobilis, Eriscion macdonaldi, Epinephelus analogus, Stereolepis ishinagi and Sphyraena argentea, containing 50 per cent of cod liver oil. It is biologi- cally assayed to have a potency of not less than 60,000 units of vitamin A (U. S. P.) per gram and of not less than 8,500 units of vitamin D (U. S. P.) per gram. Actions and Uses. — Same as those of cod liver oil. See General Article, Fish Liver Oils, Preparations and Concentrates. 472 NEW AND NONOFFICIAL REMEDIES Dosage. — Prophylactic, for normal infants 10 drops daily ; curative, and in severe conditions, to 20 drops daily. The product is marketed with a dropper designed to deliver 3 drops to the minim. Percomorph liver oil, 50%, in cod liver oil, is a yellow to brownish yellow, oily liquid. It has a slightly fishy but not rancid odor and a fishy taste. It is slightly soluble in alcohol but is soluble in ether, chloroform, benzene, carbontfisulfide and ethyl acetate. The specific gravity is from 0.922 to 0.930 at 25 C. The refractive index is from 1.480 to 1.485 at 20 C. A solution of one drop of the oil in 1 cc. of chloroform, when shaken with one drop of sulfuric acid, acquires a blue color, changing to violet, dark green, and finally brown. Treat 5 cc. of oil with 5 cc. of benzene and centrifugate for twenty-five minutes at 25 C; no pre- cipitate forms and a clear solution remains. Fill a tall, cylindric, standard oil-sample bottle of about 120 cc. capacity with percomorph liver oil, 50%, in cod liver oil, at a tem- perature between 23 and 28 C, stopper, and immerse the bottle in a mixture of ice and distilled water for five hours: the oil remains fluid and forms no deposit. Dissolve 2 Gm. of percomorph liver oil, 50%, in cod liver oil in 20 cc. of a mixture of equal volumes of alcohol and ether, which pre- viously has been neutralized with tenth-normal sodium hydroxide, using 5 drops of phenolphthalein T. S. as indicator, and titrate with tenth- normal sodium hydroxide to the production of a pink color which persists for fifteen seconds: not more than 1 cc. of tenth-normal sodium hydroxide is required {free acid). The amount of unsaponifi- able matter as determined by the method of U. S. P. XI, page 446, is not less than 3.5 per cent nor more than 7 per cent (it is semisolid in appearance). The saponification value as determined by the method of U. S. P. XI, page 445, is not less than 174 and not more than 186. The iodine value as determined by the method of U. S. P. XI, page 445, on 0.18 to 0.20 Gm. of sample, accurately weighed, is not less than 145 and not more than 180. The undiluted fixed oil obtained from the fresh livers of the perco- morph fishes and used in the preparation of percomorph liver oil 50 per cent in cod liver oil conforms to the following constants as determined by methods of U. S. P. XI: specific gravity, from 0.924 to 0.930 at 25 C; refractive index, from 1.^84 to 1.490 at 20 C; free acid in 2 Gm., equivalent to not more than 1 cc. of tenth-normal sodium hydroxide; unsaponifiable matter, not less than 7 nor more than 13 per cent (semi-solid in appearance) ; saponification value, not less than 168 nor more than 182; iodine value, not less than 145 nor more than 180. Mead's Oleum Percomorphum. — A brand of percomorph liver oil-N. N. R. Manufactured by Mead Johnson & Co., Evansville, Ind. No U. S. patent or trademark. Mead's Oleum Percomorphum, 50% (In Capsules): Each capsule con- tains 10 drops (0.222 Gm.) of Mead's Oleum Percomorphum, 50%, repre- senting a vitamin potency of not less than 13,300 vitamin A units and 1,850 vitamin D units, U. S. P. Mead's Cod Liver Oil Fortified with Percomorph Liver Oil (See under Mead's Standardized Cod Liver Oil). VIOSTEROL Investigations dealing with the chemistry and physiology of vitamin D led to the demonstration that ergosterol acquires antirachitic activity when subjected to ultraviolet irradiation. Ergosterol is a widely distributed plant sterol that was first isolated from ergot and the compound can readily be prepared VITAMIN PREPARATIONS 473 from yeast. In 1929 the Council adopted the term "Viosterol" to designate irradiated ergosterol. Since that time it has been demonstrated that other physico-chemical processes may be used to change ergosterol to a product similar in physiological, physical and chemical properties to irradiated ergosterol. Such forms of activated ergosterol, and irradiated ergosterol pre- pared by modifications of the original method, are designated as "Viosterol" followed by a designation of the process used in their preparations. The term "Viosterol in Oil" is used to designate viosterol dissolved in edible vegetable oil. COD LIVER OIL WITH VIOSTEROL (See under Cod Liver Oil and Cod Liver Oil Preparations). HALIBUT LIVER OIL WITH VIOSTEROL (See under Halibut Liver Oil and Halibut Liver Oil Preparations). VIOSTEROL IN OIL.— Irradiated Ergosterol in Oil- Activated Ergosterol in Oil. — Viosterol dissolved in a vege- table oil and standardized to contain the equivalent of at least 10,000 units (U. S. P.) of vitamin D in each Gm. Actions and Uses. — See preceding article, Viosterol. Dosage. — Daily prophylactic dose for the average infant and child, 8 to 10 drops (0.16 to 0.21 cc. : 2^ to 3^^ minims); for the premature and rapidly growing infant, 15 drops (0.31 cc. : 5 minims) ; daily curative dose, 15 to 20 drops (0.31 to 0.41 cc. : 5 to 7 minims) ; in severe cases and for adults, doses in excess of 20 drops may be given. The marketed preparations are accompanied by a standard dropper designed to deliver 3 drops to the minim. Viosterol in oil is standardized by comparison with a standard- ized reference specimen of cod liver oil. Viosterol in Oil-N. N. R. must be labeled in terms of U. S. P. units of vitamin D per Gm. Viosterol in Oil-Abbott. — A brand of viosterol in oil- N. N. R. Manufactured by The Abbott Laboratories, North Chicago, under U. S. patent 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. Viosterol in oil-Abbott is prepared by dissolving ergosterol in anhydrous, peroxide free ether-U. S. P.; the solution is filtered, placed in transparent quartz containers with reflux condensers, and exposed to ultraviolet rays at a determined distance and intensity for a determined length of time._ The irradiated ergosterol, freed of ether and dissolved in sesame oil, is biologically assayed and adjusted to have the potency of viosterol in oil-N. N. R. Mead's Viosterol in Oil. — A brand of viosterol in oil- N. N. R. Manufactured by Mead Johnson & Co., Evansville, Ind., under U. S. patent 1,680,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9, 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. 474 NEW AND NONOFFICIAL REMEDIES Mead's viosterol in oil is prepared by exposing, under reflux, an ether solution of ergosterol and an antioxidant to the radiation from an iron-cored-carbon arc. The antioxidant is then removed, the solvent evaporated to dryness, and the residue dissolved in maize oil. The resulting solution is biologically assayed and adjusted to have the potency of viosterol in oil-N. N. R. The final dilution is also biologi- cally tested. Viosterol in Oil-Merrell, Sperti Process. — A brand of viosterol in oil-N. N. R. Manufactured by William S. Merrell Company, Cincinnati, under U. S. patent 1,676,579 (July 10, 1928; expires 1945), by license of the General Development Laboratories, Inc. Viosterol in oil-Merrell, Sperti process, is prepared by irradiation of a solution of ergosterol by ultraviolet rays of predetermined or selected wavelengths, waves shorter than 2,753 angstroms being removed. After irradiation the solution is refined to remove the majority of unchanged ergosterol, the solvent is distilled off at a low temperature in an inert atmosphere, and the irradiated ergosterol is taken up in a known weight of vegetable oil. The resulting concentrate is adjusted by admixture of a bland vegetable oil so that the final product when assayed accord- ing to the U. S. P. method has not less than the vitamin D potency of viosterol in oil — N. N. R. Parke, Davis & Co.'s Viosterol in Oil. — A brand of viosterol in oil-N. N. R. Manufactured by Parke, Davis & Co., Detroit, under U. S. patent 1,683,818 (Aug. 14, 1928; expires 1945) and 1,871,136 (Aug. 9, 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. Parke, Davis & Co.'s Viosterol in Oil is prepared by dissolving crystalline ergosterol in purified ether to a definite concentration; the solution is then irradiated by exposure for a specified time to ultra- violet light of a constant artificial source; after irradiation the ether is recovered and the irradiated ergosterol is dissolved in maize oil. The final dilution and concentration is based upon the biological assay and is adjusted to have the potency of viosterol in oil-N. N. R. Viosterol in Oil-Squibb. — A brand of viosterol in oil- N. N. R. Manufactured by E. R. Squibb & Sons, New York, under U. S. patent 1,680,818, (Aug. 14, 1928; expires 1945) and 1,871.136 (Aug. 9, 1932; expires 1949) by license of the Wisconsin Alumni Research Foundation. Viosterol in oil-Squibb is prepared by dissolving ergosterol in ether; the solution is then irradiated by exposure to ultraviolet rays; after assay of the irradiated ergosterol for its antirachitic potency, it is dissolved in maize oil and adjusted to have the potency of viosterol in oil-N. N. R. Winthrop Viosterol in Oil. — A brand of viosterol in oil- N. N. R. Manufactured by the Winthrop Chemical Co., Inc., New York, under U._ S. patent 1,680,818 (Aug. 14, 1928; expires 1945) by license of the Wisconsin Alumni Research Foundation. Winthrop viosterol in oil is prepared by dissolving ergosterol in alcohol. The solution is then irradiated by exposure _ to ultraviolet rays at a determined distance and intensity. After irradiation the alcohol is distilled off in vacuo and the residue is dissolved in sesame oil and adjusted, on the basis of biologic assay, to have the potency of viosterol in oil-N. N. R. XANTHINE DERIVATIVES 475 XANTHINE DERIVATIVES Structure and Relations. — Caffeine, theobromine and theo- phylline are methyl xanthines, derived from xanthine by the introduction of two or three methyl radicals into a correspond- ing number of NH2 groups. As these may occupy various posi- tions in the xanthine nucleus, a considerable number of methyl xanthines exist, naturally or by synthesis, differing quantitatively in pharmacologic activity. Those named, however, are the only ones of therapeutic importance, namely, caffeine (1:3:7 tri- methylxanthine) ; theobromine (3 : 7 dimethylxanthine) ; and theophylline (1 : 3 dimethylxanthine). Caffeine is usually obtained from tea or coffee; theobromine is obtained from cacao, or is made synthetically. Theophylline occurs in nature but in amounts too small to be commercially available. It is prepared synthetically. Theocin is a proprietary name for synthetic theophylline. Actions and Uses. — Theobromine and theophylline surpass caffeine in their diuretic, and perhaps in cardiac and muscular actions. They are, therefore, generally preferred in cardiac edemas, etc., since they are equally, or more, effective, more prompt, and largely avoid the unpleasant side effects (insomnia, nervousness, gastric disturbance) which often interfere with the use of caffeine in adequate doses. This freedom from side effects holds true, particularly for theobromine. Theophylline surpasses theobromine in diuretic efficacy, but its action is probably not so lasting ; it may produce gastric disturbances ; renal irritation has been reported. Theobromine is, therefore, generally pre- ferred, sometimes preceded for a few days by theophylline. If central stimulation is desired, caffeine must be used. Compounds. — The slight solubility of theobromine and theo- phylline limits their usefulness. They are therefore used almost exclusively in the form of the readily soluble double salts (such as theobromine with sodium salicylate, U. S. P.), which they form with a considerable number of compounds. There is no reason to suppose that the particular salt used to procure the solubility has any material influence on the action. The dosage of these added compounds is also generally too small to produce therapeutic effects. It may, therefore, be assumed that the various preparations which have been introduced are strictly equivalent. Theobromine and Theobromine Compounds THEOBROMINE. — Theobromina. — 3,7-Dimethylxan- thine. — ■ C5H2(CH8)2.02N4. A base occurring in Theobroma cacao; also made synthetically. Actions and Uses. — The uses of theobromine are similar to those of caffeine, but its action is said to be relatively greater on the heart and muscles and also as a diuretic. It does not act so powerfully on the central nervous system. 476 NEW AND NONOFFICIAL REMEDIES It is used as a diuretic ; myocardial stimulant ; and as a means of obtaining relief of pain in angina and similar lancinating pains (this effect is obtained more frequently with theophylline). Though theobromine (and theophylline) have been used for lowering hypertension, the evidence for this action does not seem to warrant this use. The great obstacle to its use has been its insolubility and the consequent uncertainty of the degree of its absorption. It is liable to produce gastric disturbances. Dosage. — From 0.35 to 0.5 Gm. (5 to 8 grains). Theobromine occurs as colorless, rhombic needles or as a white crystalline powder, odorless, bitter, and permanent in the air. Theobromine is slightly soluble in water, alcohol, ethyl acetate and chloroform, and insoluble in petroleum ether. It is soluble in aqueous solutions of the alkalis. Dissolve about 0.01 Gm. of theobromine in 1 cc. of hydrochloric acid in a porcelain dish, add 0.1 Gm. of potassium chlorate, evaporate the mixture to dryness on a water bath and invert the dish over a vessel containing a few drops of ammonia water: the residue acquires a purple color, which is destroyed by fixed alkalis. Add about 0.2 Gm. of theobromine to 3 cc. of water containing a few drops of diluted sulfuric acid and heat the mixture; cool, filter and add a few drops of tannic acid solution: a white precipitate is formed which is soluble in an excess of the reagent. Dissolve about 0.1 Gm. of theobromine in 50 cc. of very dilute ammonia water by the aid of a gentle heat; add an excess of silver nitrate solution; agitate the mixture and warm on the water bath: a white, crystalline precipitate forms on standing. The aqueous solution of the theobromine (1 in 2,000) is not precipi- tated by iodine solution or by potassium mercuric iodide solution (absence of most foreign alkaloids). Shake about 1 Gm. of theobromine, accurately weighed, with 10 cc. of benzol in a glass-stoppered container; allow to stand over night, filter through dry filter paper, reject the first 5 cc. of filtrate, evap- orate the succeeding 3 cc. of the filtrate, dry the residue, if any, at 100 C., and weigh: the residue should weigh not more than 0.001 Gm. (limit of caffeine). Dry about 1 Gm. of theobromine, accurately weighed, to constant weight at 100 C: the loss does not exceed 3 per cent of the weight taken (limit of moisture). Incinerate about 0.5 Gm. of theobromine, accurately weighed: the ash does not exceed 0.1 per cent. Dissolve about 0.2 Gm. of theobromine in 5 cc. of sulfuric acid: not more than a faint yellow color is produced within five minutes (organic impurities). Theobromine-Merck. — A brand of theobromine-N. N. R. Merck & Co., Rahway, N. J., distributor. THEOBROMINE SODIUM-ACETATE. — Theobro- minae Sodio-Acetas. — A hydrated double salt of theobromine sodium and sodium acetate, containing not less than 6?) per cent of theobromine, corresponding to about 80 per cent of the anhy- drous double salt.— NaCTHTOaNi+NaCoHaOo. Actions and Uses. — Theobromine sodium-acetate acts like theobromine, over which it has the advantages of greater solu- bility and of being well tolerated by the stomach. While inferior in diuretic power to theophylline (which see), it is said to have greater power in sustaining the diuresis produced. XANTHINE DERIVATIVES 477 Dosage. — From 0.5 to 1 Gm. (8 to 15 grains), preferably in wafers or capsules. If in solution, this should be freshly pre- pared (with peppermint water), without sugar or mucilage. Theobromine sodium-acetate is a white, finely crystalline powder, odorless and bitter. It is soluble in cold water; slightly soluble in cold alcohol; more so in hot alcohol. Its aqueous solutions are strongly alkaline toward phenolphthalein and litmus. Jt is quite hygroscopic, and in aqueous solution when exposed to air it gradually splits up into its components through absorption of carbon dioxide and becomes incompletely soluble. Its aqueous solution is precipitated and decom- posed by carbon dioxide and by acids. It forms a bluish-white pre- cipitate with silver nitrate solution, a blue precipitate with copper sulfate solution, and a white one with tartar emetic solution. It is not readily precipitated by mercuric potassium iodide solution or by iodine solution. It is incompatible with carbonated beverages, acids, saccharine and mucilaginous liquids, and most of the alkaloidal reagents. To 10 cc. of an aqueous solution of theobromine sodium-acetate (1 in 50) add 2 cc. of diluted nitric acid, filter and add a few drops of silver nitrate solution to the filtrate: not more than an opalescence results {limit of chloride). Dry about 1 Gm. of theobromine sodium-acetate, accurately weighed, to constant weight at 100 C. : the loss does not exceed 20 per cent. Dissolve about 1 Gm. of theobromine sodium-acetate, accurately weighed, which has previously been dried to constant weight at 100 C. in 100 cc. of hot water, add phenolphthalein solution and titrate with normal hydrochloric acid to the disappearance of the pink color: not more than Z.7 cc. of normal acid should be required for each gram. Dissolve about 0.25 Gm. of theobromine sodium-acetate, accurately weighed, which has been previously dried to constant weight at 100 C., in 100 cc. of hot water, add a few drops of potassium chromate solu- tion and titrate the solution while hot with tenth-normal silver nitrate to the formation of a reddish color; the tenth-normal silver nitrate consumed corresponds to at least 63 per cent of theobromine. Agurin. — A brand of theobromine sodium-acetate-N. N. R. Manufactured by Winthrop Chemical Company, Inc., New York, trademark 36,018. Theobromine and Sodium Acetate-Merck. — A brand of theobromine sodium-acetate-N. N. R. Manufactured by Merck & Co. Inc., Rahway, N. J. No U. S. patent or trademark. Theobromine and Sodium Acetate-Roche. — A brand of theobromine sodium-acetate-N. N. R. Manufactured by F. Hoffmann-La Roche & Co., Basle, Switzerland (Hoffmann-La Roche, Inc., Nutley, N. J.). THEOCALCIN.— A double salt or mixture of calcium theobromine ([C7H702N4]2Ca) and calcium salicylate ([C7H5 OsJsCa). It contains not less than 44 per cent of theobromine. Actions and Uses. — Theocalcin acts like theobromine, over which it has the advantage of greater solubility. It is, however, less soluble than the official theobromine with sodium salicylate: on this account it is claimed to be less likely to produce gastric irritation. 478 NEW AND NONOFFICIAL REMEDIES Do^a^^.— Average dose, from 0.5 to 1 Gm. (7 to 15 grains) three times a day. Manufactured by E, Bilhuber, Inc., Jersey City, N. J. (Bilhuber-Knoll Corporation, Jersey City, N. J., distributor.) U. S. patent 1,547,698 (July 28, 1925; expires 1942). U. S. trademark 194,898. Theocalcin Tablets, 7H Grains. Theocalcin is a white, amorphous powder, having a saline taste. It is partly soluble in water. An aqueous solution of theocalcin is alkaline to phenolphthalein. An aqueous solution of theocalcin (1 in 100), slightly acidulated with acetic acid, becomes violet on the addition of ferric chloride solution. Transfer about 0.05 Gm. of theocalcin to a test tube, add 3 cc. of diluted acetic acid and heat to boiling; cool the contents of the test tube, filter and to the filtrate add 0.5 cc. of ammonium oxalate solution: a precipitate forms, which dissolves on addition of 1 cc. of diluted hydrochloric acid. To about 0.05 Gm. of the precipitate obtained in the assay for theobromine, add 1 cc. of hydrochloric acid and about 0.1 Gm. of potassium chlorate and evaporate to dryness on a water bath: a reddish yellow residue remains, which becomes purple when moistened with a drop of ammonia water. Dried to constant weight at 110 C., theocalcin loses not more than 5 per cent (water). Treat 0.1 Gm. of theocalcin with 2 cc. of sulfuric acid: no effervescence occurs {carbonate) nor is more than a slight color produced {readily carbonizable substances). Mix 1 Gm. of theocalcin with 10 cc. of distilled water, add a few cubic centimeters of sodium hydroxide solution (filter if necessary) and shake the mixture with 10 cc. of chloroform, separate the chloroform layer, evaporate it to dry- ness on a water bath and dry to constant weight at 80 C. : the weight of the residue so obtained does not exceed 0.005 Gm. {caffeine). Suspend about 2 Gm. of theocalcin, accurately weighed, in 75 cc. of water and add diluted hydrochloric acid until the solution is acid to phenolphthalein. Warm gently, then add sodium carbonate solution until the calcium is completely precipitated, avoiding a large excess. Filter off the calcium carbonate; evaporate the combined filtrate and washings on a steam bath to 20 cc. Add diluted hydrochloric acid, drop by drop, until just acid (to phenolphthalein), then dilute ammonia water until slightly alkaline. Allow to stand at from 20 to 25 C. for three hours, stirring occasionally. Transfer the precipitate of theo- bromine to a tared Gooch crucible. Wash the precipitate and filter with four successive portions of 5 cc. each of ice cold distilled water and dry to constant weight at 100 C. To the weight of the precipitate thus obtained, add 0.14 Gm. The total weight corresponds to not less than 44 per cent of the weight of theocalcin taken. About 0.2 Gm. of the precipitate obtained in the assay for theobromine volatilizes when slowly heated, leaving only a negligible residue. Theophylline and Theophylline Compounds AMINOPHYLLINE.—Aminophyllin.— Theophylline with Ethylenediamine-U. S. P. — A double salt or mixture of theo- phylline, C5Ho(CH3)2.02N4.H20, and ethylenediamine, C2H4 (NH2)2, containing not less than 70 per cent of anhydrous theophylline (calculated to the dried specimen). Actions and Uses. — Aminophylline has the actions and uses of theophylline and theophylline with sodium-acetate, over which it has the advantage of greater solubility. Like these it has a diuretic action, produces myocardial stimulation. It has been claimed that in certain cases relief of pain has followed the use of theophylline preparations in cardiac conditions. The evidence that this was due to the theophylline is not convincing, and there is no evidence that the improvement, if it occurred, was due to coronary dilatation. XANTHINE DERIVATIVES 479 Dosage. — Orally, from 0.1 to 0.2 Gm. ; by rectal administra- tion in the form of suppositories, 0.36 Gm., or, as a retention enema, from 0.3 to 0.4 Gm. dissolved in water; intramuscularly, 0.48 Gm. ; intravenously, in emergencies only, 0.24 Gm. Aminophylline occurs as white or slightly yellowish granules, possess- ing a slight ammoniacal odor and a bitter taste; soluble in water, about 1 part in 5 parts at 25 C. ; insoluble in alcohol and ether. An aqueous solution is distinctly alkaline to litmus paper; on exposure to air it gradually absorbs carbon dioxide with the liberation of theophylline. Dissolve about 0.5 Gm. of aminophylline in 25 cc. of distilled water, previously boiled to remove carbon dioxide, add, with constant stirring, 1 cc. of diluted hydrochloric acid: collect the precipitate of theophylline on a filter paper, wash with cold water, dry at 100 C: it melts at from 267 to 272 C. Place about 0.01 Gm. of the resultant precipitate in a porcelain dish, add 1 cc. of hydrochloric acid and 0.1 Gm. of potassium chlorate, evaporate the mixture to dryness on a water-bath: on inverting the dish over ammonia, the residue assumes a purple color, readily destroyed by fixed alkalis. To the filtrate from the foregoing add 2 cc. of benzoyl chloride, followed by the addition of 5 cc. of sodium hydroxide solution, agitate the mixture and heat gently for a short time and allow to cool: collect the precipitate of ethylenediamine dibenzoate on a filter paper, wash with water and dry at 100 C: it melts at 244 C. Incinerate about 1 Gm. of aminophylline, accurately weighed: the residue does not exceed 0.1 per cent. Dry about 1 Gm. of aminophyl- line, accurately weighed, in a desiccator over calcium chloride for forty-eight hours: the loss does not exceed 4.5 per cent. Transfer about 0.2 Gm. of aminophylline, accurately weighed, to a 500 cc. Kjeldahl flask and determine the nitrogen content according to the Gunning method described in Official and Tentative Methods of Analysis of the Association of Official Agricultural Chemists, edition 3, 1930, page 20, chapter 2, paragraph 22: the percentage of nitrogen corresponds to not less than 32.2 per cent nor more than 2)2> per cent, calculated to the dried substance. Transfer about 0.15 Gm. of aminophylline to a 100 cc. volumetric flask containing 5 Gm. of sodium chloride and 10 cc. of 20 per cent hydrochloric acid, followed by the addition of 50 cc. of tenth-normal iodine solution; finally dilute with water to the final volume of 100 cc. and allow to stand for thirty minutes, shaking at intervals; filter through paper, rejecting the first 20 cc. of the fil- trate; measure accurately 50 cc. of the filtrate into an Erlenmeyer flask and titrate the excess of iodine with tenth-normal sodium thiosulfate solution, using starch-paste as an indicator; the amount of iodine con- sumed, multiplied by two and the conversion factor (0.004503 Gm.) represents the amount of theophylline present in the specimen; the per- centage of theophylline found by this method should not be less than 70 per cent nor more than 83 per cent, calculated to the dried substance. Note. — No satisfactory method for accurate determination of theophyl- line in theophylline-ethylenediamine has been found. The assay by the periodide method is only roughly approximate; it is important that as nearly exactly the specified amount of aminophylline as possible be used with iodine because the solubility of the periodide precipitate varies. This assay method of standardization is therefore at best approximate and must be considered tentative until such time as more accurate analytic procedure is available. Dubin-Aminophyllin. — A brand of aminophylline-N. N. R. Manufactured by the H. E. Dubin Laboratories, Inc., New York. No U. S. patent or trademark. Ampules Solution Dubin-Aminophyllin, 0.24 Gm., 10 cc. Ampules Solution Dubin-Aminophyllin, 0.48 Gm., 2 cc. Suppositories Dubin-Aminophyllin, 0.36 Gm. Tablets Dubin-Aminophyllin, 0.1 Gm. 480 NEW AND NONOFFICIAL REMEDIES Aminophylline-Pharmedic. — A brand of aminophylline- N. N. R. Manufactured by the Pharmedic Corporation, New York, N. Y. No U. S. patent or trademark. Ampules Solution Aminophylline-Pharmedic, 0.24 Gnu, 10 cc. Ampules Solution Aminophylline-Pharmedic, 0.48 Gin., 2 cc. Suppositories Aminophylline-Pharmedic, 0.36 Gm. Tablets Aminophylline-Pharmedic, 0.1 Gm. Aminophylline-Searle. — A brand of aminophylline-N. N. R. Manufactured by G. D. Searle & Co., Chicago. No U. S. patent or trademark. Ampules Solution Aminophylline-Searle, 0.24 Gm., 10 cc: Each ampule contains aminophylline-Searle, 0.24 Gm., in sufficient distilled water to make 10 cc. Ampules Solution Aminophylline-Searle, 0.48 Gm., 2 cc: Each ampule contains aminophylline-Searle, 0.48 Gm., benzyl alcohol 0.04 Gm., in suffi- cient distilled water to make 2 cc. Tablets Aminophylline-Searle, 0.1 Gm. (lYz grains). THEOPHYLLINE.— For standards see the U. S. Phar- macopeia under TheophylHna. Theocin. — A brand of theophylline-U. S. P. prepared syn- thetically. Manufactured by Winthrop Chemical Co., New York. U. S. patent 716,994 (Dec. 30, 1902; expired). U. S. trademark 39,135. Tablets Theocin, iy2 grains. Theocin is obtained by heating the monoformyl derivative of 1,3- dimethyl-4,5-diamido-2,6-dioxy-pyrimidin with alkalis resulting in the preliminary formation of an alkaline salt of the formyl compound. On further heating, this splits off one molecule of water, forming the alkali salt of theocin. Subsequent treatment with acids liberates theocin. THEOPHYLLINE WITH SODIUM ACETATE.— "Contains not less than 55 per cent and not more than 65 per cent of anhydrous theophylline (C-HsG^N*)." U. S. P. For standards see the U. S. Pharmacopeia under TheophylHna Cum Sodii Acetate. Dosage. — From 0.2 to 0.35 Gm. (3 to 5 grains), best given after meals. It is a white crystalline powder, containing about 60 per cent of anhydrous theophylline. It dissolves in about 20 parts of water at 25 C., but is insoluble in alcohol or ether. Theocin Soluble. — Theocin Sodium Acetate. — A brand of theophylline with sodium acetate-U. S. P. Tablets Theocin Soluble, 2J4 grains. Manufactured by Winthrop Chemical Company, New York. U. S. patent 716,994 (Dec. 30, 1902; expired). U. S. trademark 39,135. ZINC COMPOUNDS 481 ZINC COMPOUNDS The essential action of salts of zinc, like those of copper and lead, is that of an astringent or corrosive. The action of these salts being largely proportional to the concentration, zinc chloride in strong solution has been used as an escharotic, fairly strong solutions of zinc sulfate as an emetic, weaker solutions of zinc sulfate and zinc acetate as astringent and antiseptic applications to the mucous membranes of the eye, urethra, etc., while the insoluble zinc oxide is used externally as a mild antiseptic and astringent. Zinc oxide was thought to act on the nervous system; but this theory is probably incorrect, and the internal use of zinc oxide has been practi- cally abandoned. Various zinc salts containing therapeutically active acid radi- cals or anions have been used in medicine; thus in zinc per- manganate the oxidizing action of the permanganate radical is influenced beneficially, it is claimed, by the astringent action of the zinc. ZINC PERMANGANATE. — Zinci Permanganas. — Zn(MnO02+6H2O. — The zinc salt of permanganic acid. It should contain not less than 90 per cent of zinc permanganate. Actions and Uses. — Zinc permanganate resembles the potas- sium salt in its oxidizing properties, but is more astringent. It is antiseptic. It is used chiefly in urethritis, either as an injection or as a urethral douche. Dosage. — Locally, 1 part to 4,000 (1 grain in 8 fluidounces), 1.3 Gm. of zinc permanganate is equal in permanganate con- tent to 1 Gm. of potassium permanganate. Zinc permanganate occurs in dark brown, nearly black, lustrous deliquescent crystals, or crystalline masses. It is readily soluble in water (1 in 3), generally leaving a slight residue. Aqueous solutions decompose in air, but are permanent if kept in well-closed bottles, protected from light. When heated slowly, it loses water of crystalliza- tion (25.46 per cent) and oxygen, leaving a residue of zinc manganite. If heated quickly, it gives off pink vapors, or more properly, a fine dust of manganese trioxide. Zinc permanganate gives up oxygen more easily than does the potassium salt, hence great care should be taken in bringing it in contact with easily oxidizable substances. Zinc permanganate should be almost completely soluble in water. The color of the solution is discharged by alcohol, hydrogen sulfide, ferrous sulfate, oxalic acid, or hydrogen dioxide, especially if the solution is first rendered acid with sulfuric acid. If 1 pm. of the salt is dissolved in 50 cc. of water and 5 cc. of alcohol is added, a colorless solution must be obtained after boiling and filtering; if a small part of the latter, acidified with nitric acid, is tested with silver nitrate solution for chloride and with barium chloride solution for sulfate, not more than traces of either will be indicated. If zinc permanganate is examined by the method given below, the residual titration will indicate the presence of not less than 90 per 482 NEW AND NONOFFICIAL REMEDIES cent zinc permanganate, (Zn(Mn04)2-6H20). From 0.1 to 0.2 Gm. of substance is weighed, dissolved in water, filtered through asbestos, the filtrate acidulated with 5 cc. diluted sulfuric acid warmed to about 60 C, treated with an excess of tenth-normal oxalic acid, and the excess of oxalic acid determined by titration with tenth-normal potassium permanganate. Zinc Permanganate-Merck. — A brand of zinc permanga- nate-N. N. R. Merck & Co., Inc., Rahway, N. J. LIST OF ARTICLES AND BRANDS ACCEPTED BY THE COUNCIL BUT NOT DESCRIBED IN N. N. R. Medicinal Articles: Articles which have been exam- ined by the Council, which are marketed under descriptive, nonproprietary names with well established therapeutic claims, and which are held by the Council not to require description in New and Nonofficial Remedies : ABBOTT LABORATORIES Chlorcosane-Abbott Pollen Extracts Diagnostic- Abbott ARLINGTON CHEMICAL CO. Pollen Extract Diagnostic-Arlco Arlco Proteins (For Diagnosis) ROBERT A. BERNHARD Saf-T-Top Tincture Iodine, U. S. P., 2 cc. and 15 cc. Saf-T-Top Tincture Iodine, 3^2 per cent, 2 cc. and 15 cc. CALCO CHEMICAL CO. Methylene Blue-Calco Methylthionine Chloride-Calco CUTTER LABORATORY Diphtheria Antitoxin Concen- Tetanus Antitoxin Concen- trated trated. Smallpox Vaccine GILLILAND LABORATORIES, INC. Gilliland's Concentrated and Gilliland's Concentrated and Refined Diphtheria Anti- Refined Tetanus Antitoxin toxin Smallpox Vaccine HIXSON LABORATORIES, INC. Diphtheria Antitoxin Tetanus Antitoxin HOLLISTER-STIER LABORATORIES Protein Extracts Diagnostic-Hollister-Stier 484 ACCEPTED BUT NOT DESCRIBED LEDERLE LABORATORIES, INC Ferric Ammonium Citrate- Thyroid Desiccated-Lederle Lederle, Capsules 0.5 Gm. Smallpox Vaccine (Vaccine Glycerinated Allergenic Ex- Virus) tracts-Lederle Smallpox Vaccine (Lederle) Pollen Antigens Diagnostic- (Preserved with Brilliant Lederle Green) ELI LILLY & CO. Diphtheria Antitoxin -Lilly Tetanus Antitoxin (Purified, Concentrated) Smallpox Vaccine McCORMICK & CO., INC. McCormick's English Mustard. MALLINCKRODT CHEMICAL WORKS Sodium Acid Phosphate (Mo- nobasic) -Mallinckrodt MERCK & CO. Creosote-Merck Trioxymethylene-Merck Guaiacol Carbonate-Merck (Paraformaldehyde-U. S. P.) Sodium Biphosphate-Merck WM. S. MERRELL COMPANY Acid Salicylic-Merrell Natural Oil of Sweet Birch- Sodium Salicylate-Merrell Merrell MONSANTO CHEMICAL WORKS Chlorcosane-Monsanto NATIONAL DRUG CO. Diphtheria Antitoxin Smallpox Vaccine (Vaccine Pollen Extracts Diagnostic Virus) Tetanus Antitoxin NEW YORK CITY DEPARTMENT OF HEALTH Tetanus Antitoxin Diphtheria Antitoxin (Glob- ulin) PARKE, DAVIS & CO. Diphtheria Antitoxin (Concen- Protein Extracts Diagnostic- trated Antidiphtheric Serum P. D. & Co. Globulin) Tetanus Antitoxin Globulin Group Protein Extracts-Diag- Vaccine Virus (Glycerinated) nostic-P. D. & Co. ACCEPTED BUT NOT DESCRIBED 485 SHARP & DOHME Diphtheria Antitoxin Pollens Dried-Mulford Vaccine Virus (Smallpox Vac- Proteins Dried-Mulford cine) Tetanus Antitoxin Pollen Extracts Diagnostic- Tincture Digitalis, Purified, S. Mulford & D. E. R. SQUIBB & SONS Diphtheria Antitoxin-Squibb Smallpox (Variola) Vaccine (Glycerinated) Tetanus Antitoxin, Purified STEVENSON MINERAL OIL CO. Stevenson's Heavy Russian Mineral Oil UNITED STATES STANDARD PRODUCTS CO. Ampoule Solution Quinine and Magnesium Sulphate 25% in Urea Hydrochloride 0.5 Gm., 5 cc. Ampuls 1 cc. Smallpox Vaccine (Vaccine Diphtheria Antitoxin Refined Virus) and Concentrated Tetanus Antitoxin W. T. WAGNER'S SONS CO. Wagner's Artificial Vichy Wagner's Artificial Vichy Citrated Nonmedicinal Articles. — Articles which have been examined by the Council, which are not advertised as therapeutic agents, the composition or essential ingredi- ents of which are quantitatively declared on the label or in the advertising, and the use of which under ordinary circumstances is, in the opinion of the Council, not contrary to the public welfare : AAIERICAN ANTIFORMIN CO. Antiformin (a strongly alkaline solution of sodium hypochlorite) BELLE ALKALI CO. Dichlormethane Solvent CHILD WELFARE GUILD, INC. Bite-X JOHNSON & JOHNSON K-Y Lubricating Jelly ELI LILLY & CO. Lubricating Jelly McNEIL LABORATORIES, INC. Lubricant-McNeil MERAX, INCORPORATED Merax Mercury Cyanide Solution OHIO CHEMICAL AND MANUFACTURING CO. Ohio Carbon Titrachloride Compound GENERAL INDEX Index to Accepted Articles, Rules of the Council (capitals), and 'Articles Accepted but Not Described" (italic). Abbott's A-B-D Malt Extract with Cod Liver Oil and Viosterol 459 Cod Liver Oil 460 Cod Liver Oil with Viosterol 463 Haliver Oil, Plain 468 Haliver Oil Plain Capsules, 3 minims '. . 468 Haliver Oil with Viosterol 470 A-B-D Malt Extract with Cod Liver Oil and Viosterol, Abbott's 459 Acceptance, Duration of 12 Not an Indorsement 12 Seal of 12 Acetannin 440 Acetarsone 92 -Abbott 93 Acetonebromoform 145 Acetone-Chloroform 165 Acetophenetidin 340 acetphenetidinum U.S. P. X 340 acetylaminohydroxyphenylarsonic Acid 92 acetyl-/'-aminophenyl Salicylate 341 Acetylsalicylic Acid 356 Acid-Heyden 356 Acid-Mallinckrodt 356 Acid-Merck 356 Acid (Aspirin) -Monsanto 356 Acid Type (Acid Derivatives of Salicylic Acid) 355 Acetyltannic Acid 440 Acid Derivatives of Salicylic Acid (Acetylsalicylic Acid Type) 355 Salicylic-Merrell 484 Acne Bacillus Vaccine 407 Bacillus Vaccine (Cutter) 407 Bacterin (Mulford) 408 Serobacterin-Mulford (Sensitized Acne Vaccine Polyvalent) 417 Vaccine Lederle) 408 Vaccine (Squibb) 408 Acriflavine 199 -Abbott, Neutral 200 Hydrochloride 198 Hydrochloride-Abbott 199 Hydrochloride-Abbott, Tablets, 0.03 Gm 199 "National" 199 Neutral, Abbott, Enteric Coated Tablets, 0.03 Gm. (J/^ grain).... 200 Neutral, Abbott for Intravenous Injection, 0.1 Gm. Ampules 200 Neutral, Abbott, Tablets, 0.03 Gm. (J^ grain) 200 Neutral-Calco 200 Neutral-Calco, Tablets, 5^ grain (uncoated) 200 Neutral, Jelly 1 :1,000-Abbott 200 Neutral, "National" 200 Neutral, "National." Enteric Coated Tablets, 0.0324 Gm. (^ grain) 200 Neutral, "National" Ointment, 1 per cent 200 Neutral, "National" "Pro Injectione," 0.5 Gm. vials.; 1.0 Gm. vials 200 Neutral, "National," Tablets, 0.1 Gm. (1^ grains) 200 Activated Ergosterol in Oil 473 Adalin 147 Tablets, 5 grains (0.3 Gm.) 147 Adrenalin 222 and Chloretone Ointment 222 and Cocaine Tablets 222 and Compound Yellow Oxide Ointment-M. E. S. Co 301 and Holocaine Ointment-M. E. S. Co 65 Chloride Solution 222 488 GENERAL INDEX Chloride Solution, Ampoules, 1:10,000; 1 cc; 1:2,600, 1 cc; 1:1,000, 1 cc 223 Hypodermic Tablets and Apothesine (% grain); (4 4^ grains).... 55 Inhalant 222 Ointment 222 Suppositories 222 Tablets, 2/200; ¥200 grain 222 Advertisements in Foreign Countries 17 Advertising (Comments), Rule 3. — Direct Advertising — Lay.... 16 Direct. — Rule 3 9 Indirect. — Rule 4 10 Lay Advertising (Comments), Rule 3 — Direct 16 Use of Articles for 18 Aethylis Salicylas 357 Afenif ISO Agar-Agar 25 -Agar-Merck 25 -Agar Powder-Merck 25 -Agar Shreds-Merck 25 -Agar Shreds-Reinschild 25 and Agar Preparations 25 -Phenolphthalein 25 and Phenolphthalein, with Squibb's Mineral Oil 280 with Mineral Oil, Squibb's 280 Agents for Producing Active Immunity 385 Agurin 477 Alcohol Benzylicum 56 Alkyl Derivatives of Salicylic Acid (Methyl-Salicylate Type) 357 Allergenic Extracts-Lederle 28 Extracts-Lederle Glxcerinatcd 484 Extracts-Mulford 32 Protein Preparations 25 Allergen Solutiqns-Squibb, Pollen 36 allylispropylbarbituric acid 101 allylispropylmalonyl urea 101 Alum 48 Alumini Naphtholsulfonas 48 Aluminum Compounds 47 Alumnol 48 Alum Precipitated (Refined) Diphtheria Toxoid 401 Precipitated Refined, Diphtheria Toxoid (Cutter) 401 Precipitated Refined, Diphtheria Toxoid (Gilliland) 402 Precipitated (Refined), Diphtheria Toxoid, (Hixson Labs.) 402 Precipitated (Refined). Diphtheria Toxoid, (Jensen-Salsbery) . . . . 402 Precipitated, Refined Diphtheria, Lederle 403 Precipitated, Refined, Diphtheria Toxoid (Lee Labs.) 403 Precipitated (Refined) -Lilly, Diphtheria Toxoid 403 Precipitated. Refined Diphtheria Toxoid (N. D. Co.) 404 Precipitated (Refined), Diphtheria Toxoid (Merrell) 404 Precipitated (Refined)-P. D. & Co.. Diphtheria Toxoid 404 Precipitated, Refined, Diphtheria Toxoid-Squibb 405 Precipitated, Refined, Diphtheria Toxoid (U. S. S. P. Co.) 405 Precipitated Tetanus Toxoid 406 Precipitated (Refined), Diphtheria Toxoid (Gilliland) 402 Precipitated (Refined) Diphtheria Toxoid (Hixon Labs.) 402 Precipitated (Refined). Diphtheria Toxoid (Jensen-Salsbery Labs.) 402 Precipitated Tetanus Toxoid-Lederle, Refined 407 Precipitated, Refined Tetanus Toxoid (N. D. Co.) 407 Alurate 101 Elixir 101 Elixir (Hoffmann-LaRoche) 101 Tablets, 1 gr 101 Alypin S3 Hydrochloride 53 Tablets, Yi grain 54 Amidopyrine U.S. P. X 346 Amidopyrine, with Ortal Sodium Kapseals 109 Aminoacetic Acid 48 Acid-Calco 49 GENERAL INDEX 489 Acid-Merck 49 Acid-Pfanstiehl 49 -aminobenzoxydiethylaminoethane mononitrate (p) 70 amino-benzoyl-2-diethylaminoethanolpenta-w-borate (1-) 65 -amino-benzoyldimethylaminomethyl-butanol hydrochloride (p) 71 aminobenzoyl-2-2-dimethyl-3-diethylaminopropanol hydrochloride ip) . 60 aminobenzoyl-7-dinormalbutylaminopropanol sulfate (p) 56 Aminophyllin 478 -Dubin 479 0.24 Gm., 10 cc; 0.48 Gm., 2 cc; Ampules Solution Dubin 479 0.36 Gm., Suppositories, Dubin 479 0.1 Gm., Tablets, Dubin 279 Aminophylline 478 -Pharmedic 480 -Pharmedic 0.24 Gm., 10 cc. ; 0.48 Gm., 2 cc, Ampules Solution... 480 -Pharmedic, 0.36 Gm., Suppositories 480 -Pharmedic, 0.1 Gm., Tablets 480 -Searle 480 -Searle, 0.48 Gm., 2 cc; 0.24 Gm., 10 cc. Ampules Solution 480 -Searle, 0.1 Gm. (1^ grains). Tablets 480 Aminopyrine 346 and Aminopyrine Derivatives 346 -Abbott 346 -Merck 346 Compressed Tablets Sal-Ethyl Carbonate with 358 -Ipral Tablets, 4.33 grains 106 Ammonii Sulfoichthyolicum 434 Ammonium Ichthynatum 434 Ichthosulfonate 433 Iron Citrates, Green 270 Ampules Adrenalin Chloride Solution 1: 10,000, 1 cc; 1: 2,600. 1 cc. ; _ 1:1.000, 1 cc 223 Biliposol Solution, 2 cc 129 Bismuth Sodium Tartrate-Searle, 1.5 per cent, 2 cc; 3 per cent, 2 cc 132 Bismuth Subsalicylate 2 grains (0.13 Gm.) in Oil, 1 cc. (Cheplin) . 134 Bismuth Subsalicylate with Butyn-D. R. L., 1 cc 133 Buffered Solution of Nupercaine-Ciba 2 cc, 1 :200 64 Calcium Gluconate-Sandoz 151 Campiodol Emulsion, 20 cc 255 Cebione (Crystals), 0.1 Gm 457 Chappel Liver Extract 317 Chaulmestrol 1 cc. ; 3 cc 163 Compound Solution of Calcium Gluconate 10%, 10 cc. U.S.S.P. Co 150 Dextrose (d-Glucose) 10 Gm., 20 cc. ; 25 Gm., 50 cc; 50 Gm., 100 cc. (Lakeside Labs.) 158 Digifoline-Ciba, 2 cc 182 Diothane Hydrochloride Solution in Solution of Sodium Chloride 0.6%, 6 cc (Merrell) 59 Ephedrine Hydrochloride-Abbott, 1.05 Gm., 1 cc 219 Ephedrine-Novocain Solution, 1 cc. ; 2 cc 69 Ephedrine Sulfate-Lilly, 1 cc, 0.05 Gm 220 Ergot Aseptic, 1 cc 228 Gold Sodium Thiosulfate-Abbott, 0.01 Gm.; 0.05 Gm.; 0.1 Gm.; 0.25 Gm 239 Gold Sodium Thiosulfate-Merck. 0.01 Gm.; 0.025 Gm.; 0.05 Gm. ; 0.10 Gm.; 0.20 Gm.; 0.25 Gm.; 0.30 Gm. ; 0.50 Gm.; 1.0 Gm.. 240 Gold Sodium Thiosulfate-Searle, 5 cc 240 Gynergen, 1 cc 230 Gynergen Solution 1 :2000, 0.5 cc 229 lodobismitol with Saligenin 2 cc 142 Iron Citrate Green P. D. & Co. J4 grain, J^ grain, 1^ grains.... 270 Lipiodol-Lafay, 1 cc; 2 cc. ; 3 cc; 5 cc 257 Luminal-Sodium (Powder), 2 grains, 5 grains 116 Luminal Sodium Solution in Ethylene Glvcol, 2 cc 116 Mapharsen 0.04 Gm., 0.06 Gm.. 0.4 Gm., 0.6 Gm 84 Mercurochrome-H. W. & D., 1%, 10 cc; 20 cc. (Searle) 291 490 GENERAL INDEX Mercury Salicylate, 1 grain (0.065 Gm.) Suspended in Oil, 1 cc. (Cheplin) 287 Mercury Succinimide, Vie grain; 0.012 Gm. (I/3 grain) (S. & D.) • • 288 Metycaine 1 % , 1 cc 62 Metycaine 2% and Epinephrine (1:25,000), 1 cc 62 Metycaine 2% and Epinephrine (1:50,000), 2.5 cc 62 Novocain Solution 1 per cent 69 Novocain Solution 1 per cent, 2 cc. ; 2 per cent, 3 cc 68 Novocain Solution, 10 per cent, 2 cc. (For Spinal Anesthesia).... 68 Novocain Solution, 2 per cent with 1-Suprarenin Synthetic Bi- tartrate 1:50,000, 1 cc; 1:20,000, 1 cc; 1:50,000, 3 cc; 1:20,000, 3 cc; 1:20,000, 6 cc 68-69 Novocain Solution, 1 per cent with 1-Suprarenin Synthetic Bi- tartrate 1:50,000, 2 cc; 1:50,000, 6 cc 68 of Pitocin 334 of Pitocin, 0.5 cc. ; 1 cc 334 of Pitressin 334 of Pitressin, 1 cc 335 Ouabain-H. W. & D 186 Ouabain 0.0005 Gm. (1-128 grain)-Lilly 186 Pentobarbital Sodium-Lilly. 0.5 Gm. (/^ grains) 112 Phenoltetrachlorphthalein-H. W. & D 206 Phenobarbital Sodium (Powder) -Abbott, 0.13 Gm. (2 grains) 116 Pituitrin, 0.5 cc; 1 cc 336 Potassium Bismuth Tartrate (Aqueous)-D. R. L., 2 cc 138 Potassium Bismuth Tartrate with Butyn-D. R. L., 0.1 Gm. ; 0.2 Gm. 138 Procaine-Epinephrine, 1 cc. (Abbott) 69 Procaine Hydrochloride Crystals, Sterile, For Spinal Anesthesia, 50, 100, 120, 150. 200 mg. (Abbott) 70 Procaine Hydrochloride Solution 10%, 2 cc. For Spinal Anesthesia (Abbott) 69 Procaine Hydrochloride Solution 2%, 5 cc. (Abbott) 69 Procaine Hydrochloride-Squibb, Sterile (Crystals), for Spinal Anesthesia, 50, 100, 120, 150, 200 mg 70 Salyrgan Solution 1 cc, 2 cc 298 Scillaren-B 187 Scopolamine Stable-Roche, V200 grain, 1 cc; Vioo grain, 1 cc 361 Suprarenin Powder, 0.05 Gm 223 Suprarenin Solution 223 Sodium Amytal 0.065 Gm. (1 grain); 0.125 Gm. (1^ grains); 0.25 Gm. (3J4 grains); 0.5 Gm. (7^ grains); 1.0 Gm. (15 grains) 119 Sodium Cacodylate 0.243 Gm, (3M grains), 5 cc. (Lakeside Labs.) 95 Sodium Cacodylate-Mulford, M grain, 1 cc; 1J4 grains, 1 cc; 2 grains, 1 cc; 3 grains, 1 cc; 5 grains, 1 cc; 7 grains, 1 cc; 15H grains, 2 cc 95 Sodium Cacodylate-P. D. & Co., Glaseptic, 0.2 Gm. (3 grains), 1 cc; 0.3 Gm., (5 grains), 1 cc; 0.45 Gm. (7 grains), 1 cc; 0.1 Gm. (iy2 grains), 1 cc; 0.13 Gm. (2 grains), 1 cc; 1 Gm. (15J4 grains), 2 cc 95 Sodium Morrhuate 5% with Benzyl Alcohol (Searle) 5 cc 432 Sodium Thiosulphate (Searle), 5 cc. ; 10 cc 433 Solution Aminophyllin-Dubin, 0.24 Gm., 10 cc; 0.48 Gm., 2 cc. . 479 Solution Aminophylline-Pharmedic, 0.24 Gm., 10 cc; 0.48 Gm., 2 cc 480 Solution Aminophylline-Searle. 0.24 Gm., 10 cc; 0.48 Gm., 2 cc. 480 Solution Antimony Sodium ThioglycoUate, 0.5 per cent, 10 cc; 20 cc 76 Solution Antimony Thioglycollamide, 0.4 per cent, 10 cc ; 20 cc... 75 Solution Caffeine Sodio-Benzoate, 2 cc 153 Solution Decholin-Sodium, 5 per cent, 10 cc. ; 20 per cent, 10 cc. . 125 Solution Dextrose 50%, 20 cc. ; 50%, 50 cc. (Merrell) 158 Solution of Dextrose, 10 Gm., 20 cc; 25 Gm., 50 cc. (N. D. Co.). 159 Solution Dextrose 25 Gm. in 50 cc; 50 Gm. in 100 cc. (Wyeth) . . 60 Solution Dextrose (d-Glucose) Lilly, 25 Gm., 50 cc; 50 Gm., 100 cc 158 Solution Dextrose (d-Glucose) Lilly, 10 Gm. Buffered 20 cc; 25 Gm. Buffered 50 cc 158 Solution Dextrose (d-Glucose) Lilly, Unbuffered, 25 Gm. 50 cc; 50 Gm. 100 cc 158 GENERAL INDEX 491 Solution Dextrose (d-Glucose) U.S. P. 10 Gm. 20 cc. ; 25 Cm. 50 cc; 50 Gm. 100 cc. (Cheplin) 157 Solution Dextrose (d-GIucose) U.S.P., 25 Gm. SO cc; 50 Gm. 100 cc. (Buffered) (Cheplin) 157 Solution Dilaudid Hydrochloride, 2 rag. (1/^2 grain) 1.1 cc 306 Solution Liver Extract Concentrated-Lilly, 10 cc; 19 cc 320 Solution Liver Extract-Lilly. 10 cc 320 Solution Mercury Succinimide Yq grain (0.01 Gm.) 1 cc. (Cheplin) 288 Solution, Neo-Iopax, 20 cc 266 Solution of Nupercaine-Ciba, 5 cc, 1:1,000; 25 cc, 1:1,000 64 Solution Procaine, Hydrochloride 2%, 1 cc 67 Solution Procaine Hydrochloride and Epinephrine, 3 cc. (Cheplin) 67 Solution Procaine Hydrochloride with Epinephrine, 1 cc. (U. S. S. P. Co.) 68 Solution Procaine Hydrochloride with Epinephrine, 1 cc 68 Solution Quinine and Urea Hydrochloride, 0.5 Gm., 1 cc. {U. S. S. P. Co.) 485 Solution Silver Nitrate 1 Per Cent-Cutter 431 Solution Silver Nitrate 1 Per Cent-Lederle 431 Solution Silver Nitrate 1 Per Cent-Sharp & Dohme 431 Solution Sodium Cacodvlate 0.19 Gm. (3 grains), 1 cc. (Lakeside Labs.) 95 Solution Sodium Cacodylate, 0.2 Gm. (3 grains), 1 cc. ; 0.32 Gm. (5 grains), 1 cc; 0.45 Gm. (7 grains), 1 cc; 0.2 Gm. (3 grains), 5 cc. ; 0.32 Gm. (5 grains), 5 cc; 0.45 Gm. (7 grains), 5 cc. (U. S. S. P. Co.) 95 Solarson. 1 cc 96 Sterile Crystals Novocain for Spinal Anesthesia. 50, 100, 120, 150, _200 mg. 68 Sterile Novocain Crystals for Spinal Anesthesia, 300 mg., 500 mg. 69 Sterile Solution Dextrose, U. S. P., 5 Gm. 10 cc; 10 Gm. 20 cc; 25 Gm. 50 cc; 50 Gm. 100 cc (Miller Lab's.) 159 Sterile Solution Novocain 20 per cent, 1.5 cc ; 20 per cent, 5 cc. 68 Sterile Solution Novocain 20 per cent with 1-Suprarenin Synthetic Bitartrate 1:9,000, 1.5 cc; 5 cc 68 Synthetic Thvroxine-Roche, 1.1 cc 443 Thio-Bismol 0.2 Gm.; 2 Gm 139 Triphal, 0.025 Gm. ; 0.1 Gm 240 -Vial Solution of Dextrose. 25 Gm. 50 cc; 50 Gm. 100 cc. (N. D. Co.) 159 -Vial Sterile Solution Dextrose. U. S. P. 10 Gm. 20 cc. ; 25 Gm. 50 cc; 50 Gm. 100 cc. (Miller Lab's) 159 Amytal 102 Sodium 118 Sodium Ampoule. 0.065 Gm. (1 grain); 0.125 Gm. (1^ grains^: 0.25 Gm. (3^ grains); 0.5 Gm. (754 grains); 1.0 Gm. (15 grains) 119 Sodium Pulvules, 1 grain: 3 grains 119 Tablets, ^ grain.; % grain.; 34 grain,; l^/^ grains 102 Anaerobic Antitoxin 367 Anaesthesine 73 Anatoxin-Ramon 398 Anesthesin 72 -Abbott 73 Anesthetics SO General 50 Local S3 Local, Slightly Soluble 72 Antianthrax Serum 378 Serum (Lederle) 378 Serum-Mulford 378 Serum (P. D. & Cc.) 378 Antibacterial Serums 378 Antibodies Used for Prophylactic or Therapeutic Purposes 366 Antidiphtheric Globulins 373 Antidysenteric Serum 378 Serum (P. D. & Co.) 379 Serum (Polyvalent) (Lederle) 379 Serum (Polyvalent) (S. & D.) 379 492 GENERAL INDEX Antiformin (a strongly alkaline solution of sodium hypochlorite) (American Antiformin Co.) 485 Anti-Gas Gangrene Serum (S. & D.) 369 Antigen-Strickler, Rhus Tox 353 -Strickler, Rhus Tox. (four 1 cc. vials) 353 -Strickler, Rhus Venenata 354 -Strickler, Rhus Venenata (four 1 cc. vials) 354 Antigens Diagnostic-Lederle , Pollen 484 -Lederle, Concentrated Pollen 35 -Lederle, Pollen 37 -"National," Pollen 39 Antimeningococcic Serum 379 Serum Concentrated, Lilly 380 Serum (Gilliland Labs.) 380 Serum (Lederle) 380 Serum (N. D. Co.) 380 Serum (P. D. & Co.) 381 Serum Polyvalent (U. S. S. P. Co.) 381 Serum (S. & D.) 380 Serum (Squibb) 381 Antimony Compounds 75 Sodium Thioglycollate 75 Sodium Thioglycollate, Ampules Solution, 0.5 per cent. 10 cc; . 20 cc. 76 Thioglycollamide 75 Thioglycollamide Ampules Solution, 0.4 per cent. 10 cc; 20 cc. . . . 75 Antipneumococcic Serum, Concentrated, (Pneumococcus Antibody Globulin, Types I and II)-MuIford 384 Serum, Types I and II Combined-Mulford 383 Serum (Felton) Type I (P. D. & Co.) 382 Serum-Felton-Type I (Refined and Concentrated) (N. D. Co.) 382 Serum Types I and II Refined and Concentrated (N. D. Co.) 384 Serum, Refined and Concentrated, Bilavent (Lederle) 383 Serum, Refined and Concentrated. Type II (Lederle) 383 Serum (Felton) Types I and II Refined and Concentrated (P. D. & Co.) 384 Serums 381 Serum, Type 1 381 Serum, Type II 383 Serum Type I (Gilliland) 381 Serum, Type I-Lederle, Refined and Concentrated 381 Serum, Type I (S. & D.) 382 Serum, Types I and II Concentrated (Squibb) 384 Serum, Type I (Squibb) 382 Antipneumococcus Serum, Tvpe 1 381 Serum Types I and II Combined 383 Antipyrine 345 Compounds and Derivatives 345 Antirabic Vaccine 386 Vaccine, Pasteur (Gilliland) 386 Virus 386 Anti-Snake-Bite Serum, North American 372 Antistreptococcus Serum, Erysipelas 385 Serum Lilly (Concentrated Globulin) Erysipelas 385 Serum, _ Erysipelas (N. D. Co.) 385 Antitetanic Globulins 377 Antitoxin, Anaerobic 367 Bothrops 371 Botulinus 371 (Human) -Jensen-Salsbery, Botulinus 371 Bovine, Diphtheria 373 (Bovine), Diphtheria (S. & D.) 373 Crotalus 372 Diphtheria 373 Diphtheria (Concentrated Antidiphtheric Ser-itm Globulin) (P. D. & Co.) 484 Diphtheria, Globulin-Lederle-Modified 373 Diphtheria (Globulin) (N. Y. C. Dept. of Health) 484 Diphtheria (Hixson Laboratories, Inc.) 483 Diphtheria-Lilly (Purified, Concentrated) 484 GENERAL INDEX 493 Diphtheria, Refined and Concentrated, U. S. S. P. Co 485 Diphtheria (S. & D.) 485 Diphtheria-Squibb 485 Erysipelas Streptococcus 373 Erysipelas Streptococcus (Concentrated) -Mulford 374 Erysipelas Streptococcus Concentrated-Squibb 374 Erysipelas Streptococcus Globulin-Lederle-Modified 374 Erysipelas Streptococcus Refined and Concentrated-P. D. & Co... 374 Erysipelas Streptococcus (Refined and Concentrated), U. S. S. P. Co.) 375 Gas Gangrene (Combined) (Lilly) 369 Gas-Gangrene (Combined) Refined and Concentrated-P. D. & Co.. 370 Gas-Gangrene, "Globulin-Lederle-Modified" (Polyvalent without Tetanus Antitoxin 1 . . . 368 Meningococcus 375 Menii'igococcus-P. D. & Co 375 Perfringens (S. & D.) .•••:•• ^69 Polyanaerobic, Prophylactic (Tetanus-Gas Gangrene Antitoxin) (Cutter) 367 Refined and Concentrated (Cl. Perfringens — CI. Septique Anti- toxin) (N. D. Co.) 369 Scarlet Fever Streptococcus 376 Scarlet Fever Streptococcus, P. D. & Co 377 Scarlet Fever Streptococcus Concentrated (S. & D.) 377 Scarlet Fever Streptococcus Concentrated (Squibb) 377 Scarlet Fever Streptococcus, Globulin-Lederle-Modified 376 Scarlet Fever Streptococcus (Refined and Concentrated) (Gilliland) 376 Scarlet Fever Streptococcus, Refined and Concentrated-"National". 377 Tetanus 377 Tetanus (Hixson Laboratories, Inc.) 483 Tetamis-N. D. Co 484 -Tetanus (N. Y. C. Dept. of Health) 484 -Tetanus (U. S. S. P. Co.) 485 Tetanus-Gas-Gangrene (Combined) (Prophylactic) Refined and Concentrated-P. D. & Co 370 Tetanits, Concentrated (Cutter) 483 Tetanus Gas-Gangrene, Mixed-Mulford _. 369 Tetanus Gas-Gangrene, "Globulin-Lederle-Modified" 367 (Tetanus-Gas-Gangrene) Refined and Concentrated (U. S. S. P. Co.), Polyanaerobic 371 Tetanus, Globulin-Lederle-Modified 378 Tetanus, Globulin (P. D. & Co.) 484 Tetanus, Purified (Squibb) 485 -Toxin Mixture 389 -Toxin Mixture, Diphtheria 389 -Toxin Mixture, Diphtheria (Diphtheria Prophylactic (N. D. Co.). 390 -Toxin Mixture, Diphtheria (Diphtheria Prophylactic), (Goat) P. D. & Co 390 -Toxin Mixture, Diphtheria, 0.1 L-f (Gilliland) 390 -Toxin Mixture, Diphtheria, 0.1 L-f (Hixson Labs.) 390 -Toxin Mixture. Diphtheria, 0.1 1.+ (Sheep) (Hixson Labs.) 390 -Toxin Mixture, Diphtheria (0.1 L-f) (Lederle) 390 -Toxin Mixture, 0.1 L-f Non-Sensitizing (Sheep) Diphtheria (U. S. S. P. Co.) 391 -Toxin Mixture, New Formula (Park-Banzhaf's) 0.1 L-f, Diph- theria (S. & D.) 390 -Toxin Mixture (New Formula) (Sheep)-Squibb, Diphtheria 391 Antitoxins 366 Antivenin (Bothropic)-S. & D 371 (Nearctic Crotalidae) 372 Apothesine 54 and Adrenalin Hypodermic Tablets (% grain) ; A^a grains) 55 Hydrochloride 54 Hypodermic Tablets 0.08 Gm. (ly^ grains) 55 Solution 55 Arbutin 76 -Abbott 77 -Merck 77 494 GENERAL INDEX Argenti Chloridum Colloidale Saccharatum-Hille 427 Lactas 430 Oxidum CoUoidale-Mulford 426 Argento-Proteinum Forte U. S. P. X 426 Proteinum Mite U. S. P. X 426 Argentum Arsphenamina 87 Colloidale 427 Crede 427 Argyn 426 Tablets, 6 grains 426 Arheol (Astier) 360 (Astier) Pearls 360 Aristol 249 Arlco Proteins (For Diagnosis) 483 Aromatic Chlorazene Powder 246 Arsenic Compounds 77 Pentavalent, Compounds Containing 92 Trivalent, Compounds Containing 80 Arsphenamine 80 -D. R. L 81 -Mallinckrodt 81 -Merck 82 -Merck, 0.1 Cm., 0.2 Gm., 0.3 Gm., 0.4 Gm., 0.5 Gm., 0.6 Gm. Ampules 82 -Searle 81 Silver 87 -Squibb 81 Aspirin 356 Atropine Derivatives and Analogues 98 Attenuated Living Viruses 386 Attitude on Mixtures 9 Autolyzed Liver Concentrate-Squibb 313 Azochloramid 243 Buffered Saline Mixture (for preparing 1 gallon of a 1:1,600 aqueous solution) 244 Buffered Saline Mixture (for preparing 1 gallon of a 1:3,300 aqueous solution) 244 Buffered Saline Mixture (for preparing 1 liter of a 1:1,600 aqueous solution) 244 Buffered Saline Mixture (for preparing 1 liter of a 1: 3,300 aqueous solution) 244 in Triacetin 1 : 500 244 Solution in Triacetin 1:125 244 B. Acidophilus Milk, Chenlin's 277 Acidophilus Milk, Sheffield 278 Acidophilus Milk, Supplee 278 Bacillen Emulsion "B.E." (Mulford) 395 Bacilli Emulsion 394 Bacillus Emulsion (Tuberculin "B.E.") (Lederle) 395 Vaccine, Acne 407 Bacterial Toxin 396 Toxin, Modified 398 Vaccine Made from the Typhoid Bacillus 412 Vaccine made from the Typhoid Bacillus and the Paratyphoid "A" and "B" Bacilli 413 Vaccines 407 Bacterin, Acne (Mtilford) 408 Cholera (Cholera Vaccine) (Mulford) 409 Furunculosis- Abbott (Mixed) 410 Mixed (Triple Vaccine) Typho (S. & D.) 415 Plague (Mulford) 410 (Prophylactic) Typhoid-Paratyphoid (Abbott) 414 Tvpho- (Mulford) 413 Barbital 103 -Abbott 103 and Barbital Compounds 99 -Mallinckrodt 103 -Merck 103 Sodium 120 GENERAL INDEX 495 Sodium-Abbott 120 Sodium-Merck 120 Barbitone 103 Barium Sulfate 121 Sulfate-Merck for X-Ray Diagnosis 121 Sulphate Pure-Mallinckrodt 121 Sulphate-Squibb for Roentgen-Ray Work 121 Basic Bismuth Nitrate 133 Bismuth Salicylate 133 Bazillenemulsion, Koch 394 Benzedrine 213 Inhaler 214 Solution 214 Benzene (Benzol)-Merck Reagent, Thiophene Free 123 Medicinal 122 Benzobis 136 Benzocaine 72 Benzol (Benzene) -Merck Reagent, Thiophene Free 123 Benzonaphthol 302 benzoyl-7-(2-methylpiperidino)-propanol hydrochloride 61 Benzyl Alcohol 56 Alcohol-Seydel 56 -Methyl Carbinamine Racemic 213 Betaine Hydrochloride 242 Betainae Hydrochloridum 242 Hydrochloride-Roche 242 Beta-Lactose 153 Betanaphthol Benzoate 302 Benzoate-Merck 303 Betanaphthyl Benzoate 302 Biebrich Scarlet Red 195 Bile Salts and Bile Salt Compounds 123 Salts-Fairchild 124 Salts-H. W. & D 125 Biliposol 129 Solution, Ampoules, 2 cc 129 Bismarsen 82 Bismo-Cymol 130 Cymol Ampoules, 1 cc. ; 2 cc 130 Bismosol 131 Ampoules, 1 cc 131 Bismuth Arsphenamine Sulfonate 82 Betanaphthol-Merck 132 Betanaphthol 132 Compounds 126 methoxy hydroxy benzoate, basic 136 Paste Surgical-P. D. & Co 133 Potassium Tartrate 137 Potassium Tartrate (Aqueous)-D. R. L., 2.5 per cent 138 Potassium Tartrate (Aqueous)-D. R. L., Ampules, 2 cc 138 Potassium Tartrate-D. R. L 138 Potassium Tartrate with Butyn-D. R. L., 10 per cent 138 Potassium Tartrate with Butyn-D. R. L., Ampules, 0.1 Gm. ; 0.2 Gm 138 Subsalicylate 2 grains (0.13 Gm.) in Oil, 1 cc. Ampules (Cheplin) 134 Subsalicylate in Oil-P. D. & Co., 2 ounce bottle 134 Salicylate in Oil-P. D. & Co., Glaseptic Ampules, 1 cc 134 Sodium Tartrate-Searle 132 Sodium Tartrate-Searle, Ampoules, 1.5 per cent, 2 cc; 3 per cent, 2 cc 132 Sodium Tartrate-Searle, Solution, 1.5 per cent, 60 cc. vial; 3 per cent, 60 cc. vial 132 Subnitrate 133 Subsalicylate 133 Subsalicylate with Butyn-D. R. L., Ampoule, 1 cc 133 Subsalicylate-Merck 134 Salicylate in Oil-U. S. S. P. Co 134 Subsalicylate with Butyn-D. R. L., 60 cc. Bottle 133 496 GENERAL INDEX Tribromphenate 134 Tribromphenol 134 Bismuthi Tribromphenas 134 Bite-X (Child Welfare Guild, Inc.) 485 Bivalent Antipneumococcic Serum, Refined and Concentrated (Lederle) 383 Bitumen Sulphonatum, N. F. V 433 Borcherdt's Malt Extract with Cod Liver Oil 459 Boro-Chloretone 165 Bothrops Antitoxin 371 Botulinus Antitoxin 371 Antitoxin (Human) -Jensen-Salsbery 371 Bougies, Silvol, 5 per cent 427 Bouillon Filtrate Tuberculin 396 Bovine Tetanus Antitoxin 372 Brain Extract, Solution 235 Lipoid 233 bromdiethj-lacetylurea 147 Brometone 145 Capsules. 5 grains 146 Bromine Derivatives 145 Bromsulphalein-H. W. & D 204 -H. W. & D., Solution 204 Bromural 146 Tablets, 5 grains (0.3 Gm.) 146 Brucella Melitensis Vaccine 408 Melitensis Vaccine-Lederle 408 Butamin 71 Butesin 73 1 % and Butesin Picrate \%, Ophthalmic Ointment 74 Picrate 73 Picrate Ointment with Metaphen 74 Picrate 1% and Butesin 1%, Ophthalmic Ointment 74 butyl-/'-aminobenzoate, (n) 73 -iS-bromallvl barbituric acid 112 -Chloral Hydrate 164 -Chloral Hydrate-Merck 165 ethylbarbituric acid, (n) 105 ethylmalonylurea, (n) 107 oxycinchoninic acid. 7-diethylethylenediamide hydrochloride (-a) . . 63 oxyquinolinecarboxvlic acid-4-diethylethylenediamide hydrochloride (2) : " 63 Butyn 56 and Epinephrine Hypodermic Tablets 58 2% and Metaphen 1 : 3.000, Ophthalmic Ointment 58 -D. R. L., Potassium Bismuth Tartrate with, 10 per cent 138 -D. R. L., Bismuth Subsalicylate with, 60 cc. Bottle 133 Ointment-M, E. S. Co 58 Solution, 2 per cent 57 Sulfate 56 Tablets, 0.2 Gm. (3 grains) 57 B. welchii Antitoxin 369 Caffeine Sodio-Benzoate. 2 cc. Ampuls Solution 153 with Sodium Benzoate 153 Calbroben 147 Calcii Peroxidum 339 Calcium chloride urea 150 Compounds 1 48 Creosotate 170 Dibrombehenate 147 ethylisopropylbarbiturate 105 Gluconate 150 Gluconate 10%, 10 cc. U. S. S. P. Co., Ampule Compound Solu- tion of 150 Gluconate-Merck 151 Gluconate-Pfizer 151 Gluconate-Sandoz 151 Gluconate-Sandoz, Ampules 151 GENERAL INDEX 497 lodobehenate 260 lodostearate 259 Peroxide 339 Phosphate Cocoa Wafers, Ucoline 151 Phosphate, Tribasic 151 Phosphate Tribasic-Merck 152 Calcreose 171 Compound Syrup of 171 Solution 171 Tablets, 4 grains 171 Camiofen Ointment 248 Campiodol Emulsion, Ampules, 20 cc 255 Capsules Carbon Tetrachloride (For Human Use) -P. D. & Co., 20 minims 161 Carbon Tetrachloride-S. & D., 0.3 cc; 1 cc 161 Colloidal Silver Oxide-Mulford, 3 grains 427 Digitalis Duo-Test McNeil 180 Ephedrine Hydrochloride-Abbott, ^ grain; 0.0324 Gm., (Yz grain); H grain 219 Ephedrine Hydrochloride-P. D. & Co., 3/$ grain,; ^ grain 219 Ephedrine Sulfate-Abbott. 3/$ grain; Yz grain; ii grain 220 Ephedrine Sulfate-P. D. & Co., 0.025 Gm. (^ grain); 0.05 Gm. (Va- grain) 221 I. V. C. Halibut Liver Oil, Plain, 3 minims 468 I. V. C. Halibut Liver Oil with Vitamin D Concentrate in Neutral Oil, 3 minims 471 Lipiodol-Lafay, 0.5 Gm 257 Luminal-Sodium, 5 grains 116 Neo-silvol, 6 grains (P. D. & Co.) 430 Ortal Sodium, 54 grain, (0.05 Gm.), 3 grains (0.2 Gm.), 5 grains (0.3 Gm.) 109 Silvol, 6 grains 427 Sodium Alurate. 3^ grains 117 Solution Silver Nitrate, 1 per cent-P. D. & Co., 6 minims 431 carbamido-benzenearsonic acid (p) 93 phenylarsonic acid (/>) 93 Carbarsone 93 Pulvules, 0.25 Gm. (33^4 grains) 94 Vials, 2 Gm. (31 grains) 94 Carbohydrates ... 153 for Oral Administration 153 for Parenteral Administration 154 Carbon Tetrachloride 161 Tetrachloride Compmmd, Ohio 485 Tetrachloride, Capsules, S. & D., 0.3 cc; 1 cc 161 Tetrachloride (For Human Use) -P. D. & Co., Capsules, 20 minims 161 Carbromal 147 Carboxylic Acid 167 Cargentos 426 Capsules, 3 grains 427 Ointment, 5 per cent; 10 per cent 427 Urethral Suppositories 427 Carotene 453 and Vitamin D Concentrate in Cod Liver Oil, Smaco 456 in Oil, Smaco 455 Smaco 454 with vitamin D Concentrate in Oil, Smaco 455 Cascara Sagrada, Maltine with Mineral Oil 279 Casein-Iodine 252 Castor Oil 162 Oil (Emulsion Olei Ricini-McNeil's), McNeil's Emulsion of 162 Cebione (Merck) 457 Ampules (Crystals), 0.1 Gm 457 Tablets (Crystals), 0.01 Gm.; 0.05 Gm 457 Cephalin for Local Use, Suspension of Tissue Fibrinogen and 234 Impure 233 Cevitamic Acid 451 and 456 Chappell Liver Extract (Oral) 311 Liver Extract (Subcutaneous) , 318 498 GENERAL INDEX Chaulmestrol 163 1 cc. ; 3 cc. Ampuls 163 Chaulmoogra Derivatives 162 Cheplin's B. Acidophilus Milk 277 Epinephrine Hydrochloride Solution 224 Sodium Cacodylate 0.05 Gm. (^ grain), 1 cc; 0.1 Gm. (13^ grains), 1 cc. ; 0.2 Gm. (3 grains), 1 cc; 0.3 Gm. (5 grains), 1 cc. ; 0.5 Gm. (7^ grains), 1 cc; 1.0 Gm. (15^ grains), 2 cc 94 and 95 Chiniofon 163 Powder 163 -Searle 164 -Searle Enteric Coated 0.25 Gm. (4 grains). Tablets 164 -Searle, 0.25 Gm. (4 gr.) Tablets 164 -Winthrop. 0.25 Gm. (4 grains). Tablets 164 Chloral Derivatives and Substitutes 164 Chloramina U. S. P. X 245 Chloramine Preparations 243 -T 245 -T (Monsanto) 246 -T (Squibb) 246 Chlorarsenol, Solution, 1 per cent 96 Chlorazene 246 Powder, Aromatic 246 Surgical Cream 246 Tablets, 4.6 grains 246 Chlorbutol-Acetone-Chloroform 165 Chlorbutanol (Anhydrous) -Merck 165 (Hydrous) -Merck 165 Chlorcosane 166 -Abbott 483 -Monsanto 484 Chloretone 165 and Adrenalin Ointment 222 Capsules, 3 grains; 5 grains 165 Inhalant 165 Chlorinated Paraffin 166 Chloriodized Rapeseed Oil 255 Chlorobutanol 165 Chloroxyl 168 (Lilly) 168 Tablets, 5 grains (Lilly) 168 Chocolate Tablets lodostarine-Roche 256 Cholera Bacterin (Cholera Vaccine) (Mulford) 409 Vaccine 409 Mulford Serobacterin (Sensitized Cholera Vaccine) 417 Vaccine (Prophylactic) (Lederle) 409 Vaccine, Prophylactic (Lilly) 409 Cinchophen 167 -Abbott 168 -Abbott 5 grains; 7j4 grains; Tablets 168 and Cinchophen Derivatives 166 -Calco 168 -Calco Tablets, 7^ grains 168 Hydrochloride 168 -Mallinckrodt 168 -Pfizer 168 -Squibb 168 Claims as to Origin, False. — Rule 5 10 (Comments), Rule 6. — Unwarranted Therapeutic 18 False, as to Origin (Comments), Rule 5 18 Unwarranted, Therapeutic. — Rule 6 10 Clinadol Co.'s Cod Liver Oil Concentrate 464 Clinical Evidence 19 Coated Tablets Urginin, 0.5 Gm 191 Cocaine and Adrenalin, Tablets 222 Cod-Halibut Liver Oil, Squibb 469 Cod Liver Oil 458 Liver Oil, Abbott's 460 Liver Oil and Iron Iodide, Maltine with 459 GENERAL INDEX 499 Liver Oil and Viosterol, Abbott's A-B-D Malt Extract with 459 Liver Oil Concentrate Capsules, 3 minims, White's 466 Liver Oil Concentrate, Clinadol Co.'s 464 Liver Oil Concentrate Capsules, 3 minims, Kinney's 465 Liver Oil Concentrate Liquid, Kinney's 465 Liver Oil Concentrate Liquid (Lederle) 464 Liver Oil Concentrate Liquid (Lederle) Capsules, 3 minims 464 Liver Oil Concentrate-Lederle, Tablets 466 Liver Oil Concentrate Liquid (Lederle), Vials, 5 cc 464 Liver Oil Concentrate Liquid, Vials, 5 cc, Kinney's 465 Liver Oil Concentrate Liquid, Vials, 5 cc, White's 467 Liver Oil Concentrate Liquid, Vials, 50 cc, White's 466 Liver Oil Concentrate (Liquid), White's 465 Liver Oil Concentrate Tablets, Ucoline 467 Liver Oil Concentrate Tablets, White's 467 Liver Oil Concentrate, Ucoline 466 Liver Oil, Mead's Flavored, Standardized 460 Liver Oil, Mead's, Fortified with Percomorph Liver Oil 460 Liver Oil, Mead's Standardized 460 Liver Oil, Nason's Palatable 460 Liver Oil, Parke, Davis & Company Standardized 460 Liver Oil, Patch's Flavored 461 Liver Oil-P. D. & Co. with Malt Extract 461 Liver Oil Scott's (Flavored) Norwegian 461 Liver Oil Scott's (Plain) Norwegian 461 Liver Oil, Soluble Gelatin Capsules, Parke, Davis & Company's Standardized, 10 minims 461 Liver Oil, Soluble Gelatin Capsules, Parke, Davis & Company's Standardized, 10 minims; 20 minims; 2.5 Gm.; 5 Gm 461 Liver Oil, Squibb 462 Liver Oil, Squibb Mint-Flavored 462 Liver Oil, Ucoline Standardized 462 Liver Oil with Maltine 459 Liver Oil with Viosterol 462 Liver Oil with Viosterol, Abbott's 463 Liver Oil with Viosterol, Mead's 463 Liver Oil with Viosterol, Mint-Flavored, Squibb 463 Liver (Dil with Viosterol, Parke, Davis & Company's 463 Liver Oil with Viosterol, Squibb 463 Collargol 427 Ointment 427 Collargolum 427 Colloidal Mercury Sulphide-Hille Solution 299 Silver 427 silver iodide compound 429 Silver Oxide Urethral Suppositories or Bougies-Mulford 427 Silver Preparations 422 Comments on the Rules, Explanatory 11 Complex Iron Salts 270 Iron Salts — Hemoglobin Derivatives 271 Composition. — Rule 1 9 — Secrecy Objectionable (Comments). — Rule 1 15 Statement of 15 Compound Syrup of Calcreose 171 Yellow Oxide and Adrenalin Ointment-M. E. S. Co 301 Compounds Containing Pentavalent Arsenic 92 Containing Trivalent Arsenic 80 Compressed Tablets, Protan, 5 grains 440 Tablets Sal-Ethyl Car-Bonate, 5 grs 358 Tablets Sal-Ethyl Carbonate with Aminopyrine 358 Tablets Sal-Ethyl Carbonate with Phenacetin 358 Concentrated Antipneumococcic Serum, Type I-Lederle, Refined.... 381 Anti-Pneumococcic Serum, Types I and II (Squibb) 384 Diphtheria Antitoxin 373 Pollen Antigens-Lederle 35 Pollen Extracts-Abbott 35 Liver Extract-Armour 311 Tetanus Antitoxin 377 Tuberculin 392 500 GENERAL INDEX Constituents, Nonofficial 15 Contents of N. N. R 9 Copper Citrate 169 Citrate-Mallinckrodt 170 Citrate Ointment (5 per cent; 10 per cent) M. E. S. Co 169 Salts 169 Sulfate 170 Copyrights (Comments), Rule 9 — Patents, Trademarks 23 Cremo-Bismuth 134 Creosotal-Winthrop 171 Creosote 171 and Guaiacol Compounds 170 Carbonate 171 ■Merck 484 Phenylpropionate 172 Cresatin 175 -Dr. N. Sulzberger (S. & D.) 175 Cresol 174 and Cresylic Acid Preparations 174 Derivatives 175 Cresyl Acetate 175 Cresylic Acid Preparations, Cresol and 174 Crotalus Antitoxin 372 Croton Chloral Hydrate 164 Crude Tuberculin 392 Crystallizable Benzol 122 Crystallized Strophanthin 186 Crystal Violet 211 Violet Jelly-Calco 212 Violet Medicinal-Calco 212 Cupric Citrate 169 Sulfate 170 Cuprum Citricum 169 Cyclobarbital 113 cyclohexenyl ethyl barbituric acid 113 Decholin 124 Sodium 125 -Sodium, Ampoules Solution, 5 per cent. 10 cc; 20 per cent, 10 cc. 125 Tablets, 3 ^A grains 124 Definition of Proprietary Articles 9 Dehydrocholic Acid 124 Desiccated, defatted, hog stomach 316 Dextrose 154 Ampule Solution, 25 Gm. in 50 cc; 50 Cm. in 100 cc. (Wyeth) . . . 160 Ampul Solution of, 10 Gm., 20 cc; 25 Gm., 50 cc. (N. D. Co.)... 159 Ampul-Vial Solution of, 25 Gm., 50 cc; 50 Gm., 100 cc. (N. D. Co.) 159 and Sodium Chloride Ampules, Solution, 20 cc. (Searle) with Benzyl Alcohol 159 (d-Glucose), Ampoules, 10 Gm., 20 cc; 25 Gm., 50 cc. ; 50 Gm., 100 cc. (Lakeside Lab's) 158 (d-Glucose) U. S. P., Ampules, 10 Gm., 20 cc; 25 Gm., 50 cc; 50 Gm., 100 cc. (Cheplin) 157 (d-Glucose) U. S. P., Ampules. 25 Gm., 50 cc; 50 Gm., 100 cc. (Buffered) (Cheplin) 157 5%, 10 %, 25% in Distilled Water in Filtrair Container (Hospital Liquids, Inc.) 158 5%, 10 %_ in Physiologic Sodium Chloride Solution in Filtrair Container (Hospital Liquids, Inc.) 158 in Physiological Sodium Chloride Solution in Vacoliter Container, Sterile 2^^%, 5%, 754%, 10% (Am. Hosp. Sup. Corp.) .. 156-157 5% in Physiological Solution of Sodium Chloride, Sterisol Ampoule 159 Solution, 50 Gm., 50 cc; 50 Gm., 100 cc. (U. S. S. P. Co.) 160 Solution in Vacoliter Container, Sterile 2^4%, 5%, 7^4 %, 10%, 20%, 25% (Am. Hosp. Sup. Corp.) 156 Solution U. S. P. 20%, 25% in Fractionally Distilled Water in Saftiflask Container (Cutter) 157 Solution U. S. P. 21^ %. 5%. 10% in_ Physiologic Solution of Sodium Chloride in Saftiflask Container (Cutter) 1.57 GENERAL INDEX 501 U. S. p., Ampoule Sterile Solution, 5 Gm., 10 cc; 10 Gm., 20 cc; 25 Gm., 50 cc; 50 Gm., 100 cc. (Miller Lab's) 159 U. S. P., Ampoule-Vial Sterile Solution, 10 Gm., 20 cc; 25 Gm., 50 cc; 50 Gm., 100 cc. (Miller Lab's) 159 U. S. P. (d-Glucose), 25 Gm., 50 cc Ampoule (Buffered) (S. & D.) 159 U. S. P. (d-Glucose), 25 Gm., 50 cc. Ampoule (Unbuffered) (S. & D.) 159 U. S. P., Glaseptic Ampoules Solution, 50 per cent, 20 cc; 50 per cent. 50 cc; 50 per cent, 100 cc. (P. D. & Co.) 159 -U. S. P., Solution, 25 Gm., 50 cc; SO Gm., 100 cc in Bottles (Cutter) 157 -U. S. P., Solution, 5%, 10% in Saftiflask Containers (Cutter)... 157 diacetylaminoazotoluene 196 diacetyldihydroxyphenylisaton ... 271 Diacetyltannic Acid 440 Diagnostic Agents 418 Reagents 14 Dial-Ciba 103 -Ciba, Elixir of 104 -Ciba, Tablets, 0.1 Gm. (VA grains) 104 -Ciba with Urethane, Sterile Ampules, Solution, 1 cc, 2 cc 104 diallybarbituric Acid 103 dialylmalonylurea 103 diaminoacridinium monohydrogen sulfate (3:6) 201 diaminodihydroxyarsenobenzene Hydrochloride 80 Diarsenol 82 0.1 Gm., 0.2 Gm., 0.3 Gm., 0.4 Gm., 0.5 Gm., 0.6 Gm., 1 Gm., 1 .2 Gm., 2 Gm, 3 Gm, Tubes 82 Dibromin 176 Capsules, 6 grains (P. D. & Co.) 176 (P. D. & Co.) 176 dibromobarbituric acid 176 dibromomalonylureide ^ 176 dibutylaminopropyl-p-aminobenzoate-N-Sulfate (7) 56 Dichloramina U. S. P. X 246 Dichloramine-T 246 -T (Abbott) 247 -T (Monsanto) 247 Dichlormethane Solvent (Belle Alkali Co.) 485 Dick Test: Scarlet Fever Streptococcus Toxin for the Dick Test (Lederle) 421 Test: Scarlet Fever Streptococcus Toxin for the Dick Test- Mulford 421 Test: Scarlet Fever Streptococcus Toxin for the Dick Test "National" 421 Test: Scarlet Fever Streptococcus Toxin for Dick Test-P. D. & Co. 421 Test: Scarlet Fever Streptococcus Toxin for Dick Test-Squibb. . . . 421 Test: Scarlet Fever Streptococcus Toxin for Dick Test (U. S. S. P. Co.) 421 Test: Scarlet Fever Toxin for immunization of Dick Test 396 -diethylamino-i3-/3-dimethylpropyl-p-aminobenzoate hydrochloride (7) . . 60 -diethylaminoethyl-p-aminobenzoate penta m-borate (^3) 65 -diethylaminopropyl cinnamate hydrochloride (7) 54 diethylbarbituric acid 103 diethylmalonylurea 103 Digalen Injectable-Roche 181 -Roche 181 -Roche (Cloetta) 181 -Roche (30 cc. vials) 181 -Roche, Tablets ^ cat unit; 1 cat unit 181 Digestive Enzymes 176 Digifoline-Ciba 181 -Ciba, Ampules, 2 cc 182 -Ciba Liquid 182 -Ciba, Tablets 182 Digipoten 192 Tablets : digipoten 0.03 Gm. ( i/^ grain) 192 Digitalein, Crude 183 Digitaline Cristallisee (Nativelle) 184 502 GENERAL INDEX Digitalin, "French" 183 "German" 184 Digitalis 180 and Digitalis-Like Principles and Preparations 178 (Davies, Rose) Pil 180 Duo-Test McXeil. Capsules 180 Leaf Defatted, Wyeths Capsules 180 Leaves-Squibb, Tablets. 1 cat unit 180 -Like Principles and Preparations, Digitalis and 178 -Mulf ord, Fat-Free Tincture of 193 Preparations 192 Principles 179 -Squibb Tablets, 1 grain 180 Whole Leaf-Lederle, 54 grains; IJ/2 grains; 3 grains. Tablets 180 -Wilber, Tablets, 1^ grains 180 Digitan 192 Ampules (for Hypodermic Use) 193 Tablets, l^^ grains (0.1 Gm.) 193 Tincture 193 Digitol 193 Digitoxin 184 -Merck 185 dihydro-morphinone hydrochloride 305 diiodohydroxypropane 252 diiodopropane-2-ol (1.3) 252 diiodo-4-pyridone-A'-acetic acid and diethanolamine (3,5) 261 Diiodotariric acid 256 Dilaudid Hydrochloride 305 Hydrochloride, Ampules Solution, 2 mg. (1/32 grain), 1.1 cc 306 Hydrochloride Compounding Tablets, Yi grain 306 Hydrochloride, Hypodermic Tablets, 2 mg. (1/32 grain); l.l mg. (1.20 grain) ; 4 mg. (1/16 grain) 306 Hydrohloride, Rectal Suppositories, 1/24 grain 306 Hydrochloride, Tablets, 2.5 mg. (1/24 grain) 306 Diluted Erythrityl Tetranitrate-U. S. P 304 Erythrol Tetranitrate 304 Dimazon 196 Oil (Kalle) 196 Ointment (Kalle) 196 Powder (Kalle) 196 dimethylaminophenyldimethylpyrazolon 346 dimethylxanthine. (3.7-) _. 475 dinormalbutyl-p-aminobenzoate-trinitrophenol 73 Diodrast 261 Sterile Solution 10 cc. ; 20 cc. size ampule 262 Diothane 58 Hydrochloride ._ 58 Hydrochloride Solution in Solution of Sodium Chloride, Ampules, 0.6%, 6 cc. (Merrell) • 59 Ointment, 1 % 59 Ointment, 1 % (Merrell) 59 Ointment, 1 % in Ophthalmic Tube 59 Solution, 1 % 59 Solution, 1% (Merrell) 59 Dioxyfluoran 202 Diphtheria Antitoxin 373 Antitoxin, Bovine 373 Antitoxin (Bovine) (S. & D.) 373 Antitoxin (Concentrated Antidiphtheric Serum Globulin) (P.. D. & Co.) 484 Antitoxin Concentrated (Cutter) 483 Antitoxin, Gilliland's Concentrated and Refined 483 Antitoxin, Globulin-Lederle-Modified 373 Antitoxin (Globulin) (N. Y. C. Dept. of Health) 484 Antitoxin (Hixson Laboratories, Inc.) 483 Antitoxin-Lillv (Purified Concentrated) 484 Antitoxin-N. D. Co 484 Antitoxin (S. & D.) 485 Antitoxin-S quibb 485 Antitoxin Refined and Concentrated (U. S. S. P. Co.) 485 GENERAL INDEX 503 Prophylactic 398 Toxin-Antitoxin Mixture 389 Toxin-Antitoxin Mixture, Diphtheria Prophylactic (Goat) (P. D. & Co.) 390 Toxin-Antitoxin Mixture, (Diphtheria Prophylactic (N. D. & Co.). 390 Toxin-Antitoxin Mixture, 0.1 L-f- (Gilliland) 390 Toxin-Antitoxin Mixture, 0.1 L-f (Hixson Labs.) 390 Toxin-Antitoxin Mixture (0.1 L-f) (Lederle) 390 Toxin-Antitoxin Mixture, New Formula (Park-Banzhaf's 0.1 L-f) (S. & D.) 390 Toxin-Antitoxin Mixture (New Formula) (Sheep)-Squibb 391 Toxin-Antitoxin Mixture 0.1 L-f Non-Sensitizing (Sheep) (U.S. S. P. Co.) 391 Toxin-Antitoxin Mixture 0.1 L-f (Sheep) (Hixson Labs.) 390 Toxin Diluted for Schick Test (P. D. & Co.) 420 Toxin for Schick Test and Control (U. S. S. P. Co.) ^ 420 Toxin Diluted for Schick Test Ready for Administration (Gil- liland) 419 Toxin for the Schick Test Diluted Ready for Use (Cutter) 418 Toxin for Schick Test, Diluted Ready for Use-Lilly 419 Toxin for Schick Test, Diluted Ready for Use-Mulford 420 Toxin for Schick Test in Peptone Solution (Lederle) 419 Toxin for the Schick Test 418 Toxin for the Schick Test (Cutter) 418 Toxin for the Schick Test (Diluted) (Hixson) 419 Toxin for the Schick Test Diluted with Peptone Solution and Ready for Use (Merrell) 419 Toxin for the Schick Test Ready to Use without Dilution (Squibb) 420 Toxoid 398 Toxoid, Alum Precipitated (Refined) 401 Toxoid Alum Precipitated, Refined (Cutter) 401 Toxoid Alum Precipitated (Refined) (Gilliland) 402 Toxoid, Alum Precipitated (Refined) (Hixson Labs.) 402 Toxoid, Alum Precipitated (Refined) (Jensen-Salsbery) 402 Toxoid (Alum Precipitated) Refined-Lederle 403 Toxoid, Alum Precipitated Refined (Lee Labs.) 403 Toxoid Alum Precipitated (Refined)-Lilly 403 Toxoid, Alum Precipitated (Refined) (Merrell) 404 Toxoid (Alum Precipitated), Refined (N. D. Co.) 404 Toxoid, Alum Precipitated (Refined) -P. D. & Co 404 Toxoid Alum Precipitated, Refined (U. S. S. P. Co.) 405 Toxoid-Cutter 398 Toxoid-Gilliland 398 Toxoid (Hixson Labs.) 399 Toxoid (Lederle) 399 Toxoid (Lilly) 399 Toxoid (Merrell) 399 Toxoid (N. D. Co. ) 400 Toxoid (P. D. & Co.) 400 Toxoid Refined Alum Precipitated-Squibb 405 Toxoid (S. & D.) 400 Toxoid-Squibb 401 Toxoid-U. S. S. P. Co 401 Direct Advertising — Lay Advertising (Comments), Rule 3 16 Advertising. — Rule 3 9 Diseases on Label, Naming 17 Disinfectants and Germicides, Standardization of 16 disodium iV-methyl-3 :S-diiodo-4-pyridoxyl-2 :6-dicarboxylate 265 phenoltetrabromphthaleinsulfonate 204 Dried Stomach 316 Dry Liver Extract 313 Dubin-Aminophyllin 479 -Aminophyllin, 0.24 Gm., 10 cc. ; 0.48 Gm., 2 cc. Ampules Solu- tion 479 -Aminophyllin 0.36 Gm. , Sunpositories 279 -Aminophyllin, 0.1 Gm., Tablets 479 Duotal 172 Tablets 5 grains 172 Duration of Acceptance 12 504 GENERAL INDEX Dyes 194 The Acridine 197 The Azo 194 The Fluorescein (Pyronine) 202 The Phenolphthalein 203 Elixir Alurate 101 Dial-Ciba 104 Dial-Ciba (Ciba) 104 Ephedrine Sulfate, 2 grains 220 of Luminal 115 of Pyramidon 346 of Veronal 103 Emulsion Mesurol, 20 per cent 136 of Castor Oil, McNeil's (Emulsum Olei Ricini-McNeil's) 162 Enteric Coated Glycotauro-H. W. & D., Tablets 125 Coated Tablets Gentian Violet Medicinal-"National," 0.0324 Gm. (i^ grain) 213 Coated Tablets Neutral Acriflavine-Abbott. 0.03 Gm. C^ grain).. 200 Coated Tablets Neutral Acriflavine-"National" 0.0324 Gm. (J/^ grain) 200 Vaccine •.••••. ^^2 Enzymes, Digestive 176 Proteolytic 177 Enzymol 177 Ephedrina Semiaquosa 217 Sicca 216 Ephedrine 215 -Abbott 216 Alkaloid-Merck 218 Anhydrous 216 Compound-Lilly, Inhalant 216 Compound, Ointment (Lilly) 216 Hemihydrate 217 Hydrochloride 218 Hydrochloride-Abbott 219 Hydrochloride-Abbott, Ampoules, 0.05 Gm., 1 cc 219 Hydrochloride-Abbott, Capsules, Vs grain; 0.0324 Gm., (y^ grain); 34 grain 219 Hydrochloride-Abbott, Syrup 219 Hydrochloride-Abbott, Tablets, ^ grain; ^ grain 219 Hydrochloride (Double Strength) -Abbott, Syrup 219 Hydrochloride-Gane and Ingram 219 Hydrochloride-Lilly 219 Hydrochloride-Lilly. Hypodermic Tablets, 0.016 Gm. (^ Gm.) ; 0.0325 Gm. (J^ grain) . . 219 Hydrochloride-Lilly, Pulvules, 0.025 Gm. (^ grain); 0.05 Gm. (3/4 grain) 219 Hydrochloride-Lilly, Solution, 3 per cent 219 Hydrochloride-Merck 219 Hydrochloride-P. D. & Co 219 Hydrochloride-P. D. & Co., Capsules, Va grain; ^ S^am 219 Hydrochloride Solution-Abbott 3% 219 Hydrochloride-Squibb 219 Hydrochloride-Squibb, Tablets, Ys grain; 3^, grain 219 Hydrochloride, Syrup 219 Inhalant-Abbott 216 Jelly, Lilly's 220 -Lilly 216 Nasal Jelly-Maltbie 220 -Novocain Solution, Ampules, 1 cc. ; 2 cc 69 (Plain)-Lilly, Inhalant 216 Sulfate 220 Sulfate-Abbott : 220 Sulfate-Abbott, Capsules, Vs grain; J^ grain; f^ gram 220 Sulfate-Abbott, Solution, 3% 220 Sulfate, Elixir, 2 grains 220 Sulf ate-Gane and Ingram 22U Sulfate-LiUy ■ • 220 Sulfate-Lilly, Ampoules, 1 cc, 0.05 Gm 220 GENERAL INDEX 505 Sulfate-Lilly, Hypodermic Tablets, 0.016 Gm. (14 grain); 0.0325 Gm. ( Yz grain) 220 Sulfate-Lilly, Solution 3% 220 Sulfate-Lilly, Syrup, 0.22 Gm. in 100 cc; 0.44 in 100 cc 220 Sulfate-Merck 221 Sulfate-P. D. & Co 221 Sulfate-P. D. & Co., Capsules, 0.025 Gm. (^ grain); 0.05 Gm. (3/^ grain) 221 Sulfate-P. D. & Co., Glaseptic Ampoules, 0.05 Gm. ()4 grain), 1 cc 221 Sulfate-P. D. & Co., Solution, 3% 221 Epinephrine 221 and Butyn Hypodermic Tablets 58 and Metycaine 2%. Ampoules 1 cc. (1: 25,000) 62 and Metycaine 2%, Ampoules, 2.5 cc. (1,:50,000) 62 and Procaine Borate Tablets 67 and Procaine Hydrochloride, 1 cc. ; 3 cc. ; Ampule Solution 68 and Related Preparations 213 Hydrochloride-Lederle, Solution 224 Hydrochloride-Lederle (Sterilized) , Solution 224 Hydrochloride, Solution (Abbott) 224 Hydrochloride Solution, Cheplin's '. 224 Hydrochloride Solution 1 :1000 (U. S. S. P. Co.) 224 Hydrochloride Solution-Wilson 224 Hydrochloride-U. S. P., Solution of 223 -Procaine Ampoules, 1 cc. (Abbott) _ 69 -Procaine Hypodermic Tablets (Procaine Y^ grain, Epinephrine V"5no grain; Procaine Yi grain, l/^oo grain) (Abbott) 69 Solution, Procaine, 100 cc. Bottle (Abbott) 69 -Wilson 224 Ergot 226 and 228 Aseptic 228 Aseptic. Ampoules, 1 cc 228 of Rye 228 Ergotamine Tartrate 229 Ergosterol In Oil, Irradiated 473 Erysipelas and Prodigiosus Toxins (Coley) (P. D. & Co.) 417 Antistreptococcic Serum 385 Antistreptococcic Serum-Lilly (Concentrated Globulin) 385 Antistreptococcus Serum (N. D. Co.) 385 Streptococcus Antitoxin 373 Streptococcus Antitoxin (Concentrated)-Mulford 374 Streptococcus Antitoxin Concentrated-Squibb 374 Streptococcus Antitoxin, Globulin-Lederle-Modified 374 Streptococcus Antitoxin Refined and Concentrated-P. D. & Co.... 374 Streptococcus Antitoxin (Refined and Concentrated) (U. S. S. P. Co.) 375 Erythrityl tetranitrate 304 Erythrol Tetranitrate, Diluted ^ 304 Tetranitrate Tablets-Merck, J/2 grain; Y\ grain 304 Tetranitrate (Undiluted) 304 Erythrityl Tetranitrate, Diluted,-!!. S. P 304 -ethanolamine-Technical (Tri-) 230 Ethyl Aminobenzcate 72 Chaulmoograte 162 Chloride 50 diiodobrassidate 258 Salicylate 357 Ethylene 50 -Cheney 51 for Anesthesia, Walco : • • • ; 51 Glycol, Ampules, Luminal Sodium Solution in, 2 cc 116 Ohio 51 (Puritan Compressed Gas Corp.) 51 Ethylhydrocupreine 232 Eucalyptus Compound Nasal Spray, Pemco Menthol 282 Eucatropine 98 Hydrochloride 98 506 GENERAL INDEX Euphthalmine 98 Hydrochloride (S. & G.) 99 Euresol (Bilhuber, Inc.) 351 Evidence, Clinical 19 Submitted 11 Exceptions (to Rule 3) 17 Explanatory Comments on the Rules 11 Extract of Liver 313 Extralin 315 Pulvules, 0.5 Gm 316 Fat-Free Tincture of Digitalis-Mulford 193 Ferri Lactas 269 Ferric Ammonium Citrate-Lederle, Capsules 0.5 Gm 484 Chloride, Solution 270 Chloride in 50% Glycerine Solution, Saf-T-Top 271 Ferrous Lactate 269 Fever Undulant Bacterial Vaccine (Jensen-Salsbery) 408 Fibrin Ferments and Thromboplastic Substances 232 Fibrogen Local-Merrell 234 Local-Merrell, 7 cc. vials 234 Fish Liver Oil Preparations and Concentrates 457 Fluorescein 202 -Merck 203 Formaldehyde Preparations 236 Preparations and Compounds which Liberate Formaldehyde 236 Solution of 237 Formalin 237 Formin 237 Tablets, 5 grains (0.3 Gm.) ; 75^ grains (0.5 Gm.) 237 Foreign Countries, Advertisements in 17 Fraud IS Previous Noncompliance and 11 Furunculosis Bacterin-Abbott (Mixed) 410 Vaccine (P. D. & Co.) 411 Gas Gangrene Antitoxin (Combined) (Lilly) 369 -Gangrene Antitoxin (Combined) Refined and Concentrated-P. D. & Co 370 Gangrene Antitoxin Refined and Concentrated (CI. Perfringens — CI. Septique Antitoxin) (N. D. Co.) 369 -Gangrene Tetanus Antitoxin (Combined) (Lilly) 369 -Gangrene Antitoxin (Combined) (Prophylactic) Refined and Con- centrated-P. D. & Co 370 -Gangrene Antitoxin (Polyvalent without Tetanus Antitoxin), "Globulin-Lederle-Modified" 368 -Gangrene Antitoxin. Tetanus, "Globulin-Lederle-Modified" 367 -Gangrene Tetanus Antitoxin Mixed-Mulford 369 Gangrene Antitoxin, Tetanus (Polyanaerobic Antitoxin, Pro- phylactic) (Cutter) 367 Gelatin Compound Phenolized 238 General Anesthetics 50 Gentian Violet Improved Medicinal 213 Violet Medicinal 212 Violet Medicinal-"National" 213 Violet Medicinal-"National," Enteric Coated Tablets, 0.0324 Gm. (^ grain) 213 Violet Medicinal-"National," Tablets, 0.0324 Gm. (i^ grain) 213 Germicidal Discs of Potassio-Mercuric lodide-P. D. & Co. (mercuric iodide 0.0971 Gm.) ; (mercuric iodide 0.0283 Gm.) 296 Germicides, Standardization of Disinfectants and..... 16 Gilhland's Concentrated and Refined Diphtheria Anti-Toxin 483 Concentrated and Refined Tetanus Antitoxin 483 Glaseptic Ampules Bismuth Salicylate in Oil-P. D. & Co., 1 cc 134 Ampoules Ephedrine Sulfate-P. D. & Co., 0.05 Gm. (H grain), 1 cc 221 Ampoules Mercury Salicylate-P. D. & Co., 0.065 Gm. (1 grain); 0.13 Gm. (2 grains) 287 Ampoules Mercury Succinimide-P. D. & Co., 0.01 Gm. (^ grain). 288 GENERAL INDEX 507 Ampoules Sodium Cacodylate-P. D. & Co., 0.2 Gm. (3 grains), 1 cc: 0.3 Gm, (5 grains), 1 cc. ; 0.45 Gm. (7 grains), 1 cc; 0.1 Gm. (11/^ grains), 1 cc. ; 0.13 Gm. (2 grains), 1 cc; 1 Gm. (15 14 grains), 2 cc 95 Ampoules Solution Dextrose, U. S. P., 50 per cent, 20 cc; 50 per cent, 50 cc; 50 per cent, 100 cc. (P. D. & Co.) 159 Ampoules Solution Liver Extract-P. D. & Co. (Intramuscular) 2 cc 319 Globulin-Lederle-Modified, Tetanus Antitoxin 378 Glucose i-d) 154 Glucosidum e scilla solubile 187 Glycerinated Allergenic Extracts-Lederle 484 Glycine 48 GlycocoU 48 Glycotauro-H. W. & D 125 -H. W. & D. Capsules, 5 grains; half size 125 -H. W. & D., Tablets, Enteric Coated 125 Glysal 359 Gold Salts 238 Sodium Thiosul fate- Abbott 239 Sodium Thiosulfate-Abbott, Ampuls, 0.01 Gm.; 0.05 Gm.; 0.1 Gm.; 0.25 Gm 239 Sodium Thiosulfate-Merck 240 Sodium Thiosulfate-Merck, Ampules, 0.01 Gm.; 0.025 Gm.; 0.05 Gm.; 0.10 Gm.; 0.20 Gm.; 0.25 Gm.; 0.30 Gm.; 0.50 Gm.; 1.0 Gm 240 Sodium Thiosulfate-Searle 240 Sodium Thiosulfate-Searle, Ampules, 5 cc 240 Granules Protargol Compound 426 Green Iron and Ammonium Citrates 270 Group Protein Extracts-Diagnostic- P. D. & Co 484 G-Strophanthin 186 Guaiacol and Creosote Compounds 170 Benzoate 171 Carbonate 172 Carbonate-Merck 484 Gynergen 229 Ampules, 1 cc 230 Solution, Ampules, 1 :2000, 0.5 cc 229 Tablets, 0.001 Gm 230 Halazone 247 -Abbott 247 -Monsanto 247 Tablets- Abbott 247 Halibut-Cod Liver Oil, Squibb 469 Liver Oil , 467 Liver Oil (In Capsules), Mead's Viosterol in 470 Liver Oil in Viosterol, Mead's 470 Liver Oil, Mead's 469 Liver Oil, Squibb Plain 469 Liver Oil With Viosterol 469 Liver Oil with Viosterol, Squibb 470 Liver Oil Plain, 11 cc, McKesson's 468 Liver Oil Plain, Capsules, 3 minims, McKesson's 468 Liver Oil, Plain, I. V. C 468 Liver Oil, Plain, 3 minims. Capsules, I. V. C 468 Liver Oil, 3 minims, Soluble CJelatine Capsules, Squibb Plain.... 469 Liver Oil with Vitamin D Concentrate in Neutral Oil, 6 cc, McKesson's 471 Liver Oil with Vitamin D Concentrate in Neutral Oil, Capsules, 3 minims, McKesson's 469 Liver Oil with Vitamin D Concentrate in Neutral Oil, I. V. C... 471 Liver Oil with Vitamin D Concentrate in Neutral Oil, 3 minims. Capsules, I. V. C 471 Liver Oil with Viosterol, 3 minims, 2 cc. Soluble Gelatine Cap- sules, Squibb 471 Haliver Oil, Plain, Abbott's 468 Oil Plain Capsules, 3 minims, Abbott's 468 508 GENERAL INDEX Oil, Plain, Parke^Davis 469 Oil, Plain 3 minims. Soluble Gelatine Capsules, Parke-Davis 469 Oil with Viosterol, Abbott's 470 Oil with Viosterol, 3 minims, Soluble Gelatin Capsules, Abbott's. . 470 Oil with Viosterol, Parke-Davis 470 Oil with Viosterol, Soluble Gelatin Capsules (Parke-Davis & Co.) . 470 Hemoglobin Derivatives, Complex Iron Salts 271 Hexamethylenamine 237 Hexamethylenetetramine 237 tetraiodide 253 hexamethylpararosaniline chloride 211 hexamethyltriamino-triphenyl-methane 211 Hippuran 263 (Crystals) 12 Gm. vial 264 25 CO., Sterile Solution 264 Hirathiol 434 Holocaine 65 and Adrenalin Ointment-M. E. S. Co 65 Hydrochloride 65 Ointment-M. E. S. Co 65 Homatropine Hydrochloride 99 Hydrochloride-Merck 99 Hydrochloride-Roche 99 Hyclorite 242 Hydrarp^ri Benzoas 283 Cyanidum 285 Nucleinas 291 Oxycyanidum 286 Hydrargyrum Benzoicum 283 Cyanatum 283 Oxycyanatum 286 Hydrochloric Acid Substitutes 241 Hyoscine Hydrobromide 361 Hypochlorite Preparations 242 and Hypochlorite Substances 242 Hypodermic Tablets Dilaudid Hydrochloride, 2 mg. (1/^2 grain) ; 3.2 mg- (V20 grain); 4 mg. (Vie grain) 306 Tablets Ephedrine Hydrochloride-Lilly, 0.016 Gm. (^ grain), 0.0325 Gm. (H grain) 219 Tablets Ephedrine Sulfate-Lilly, 0.016 Gm. (J^ grain); 0.0325 Gm. (14 grain) 220 Tablets Metrazol, 1 Yi grains 302 Tablets Strophanthin i/^oo grain (0.325 mg.)-S. & D 192 Tablets Strophanthin, i/ioo grain-Lilly 192 Tablets, Novocain, 0.2 Gm. ; 0.05 Gm 69 Tablets, Novocain, 0.02 Gm. with 1-Suprarenin Synthetic Bitar- trate, 0.02 mg 69 Hypophysis Sicca 334 Ichthammol 433 Ichthynat 434 Ichthyol (Merck & Co.) 436 Identification. — Rule 2 9 (Comments), Rule 2 16 Iletin (Insulin-Lilly) 328 (Insulin-Lilly) U-10. 5 cc. ; U-20 5 cc; U-40, 5 cc. ; U-10, 10 cc; U-20, 10 cc; U-40, 10 cc; U-80, 10 cc; U-100, 10 cc 328-329 Impure Cephalin 233 Kephalin 233 Imitations (Comments), Unessential Modifications of Official Substances 23 Indications, Therapeutic 18 Indirect Advertising. — Rule 4 10 Advertising (Comments). Rule 4 17 Inhalant Ephedrine Compound-Lilly 216 Ephedrine (Plain)-Lilly 216 Inspection of Factories 15 Insulin 323 -Lilly (Iletin) 328 GENERAL INDEX 509 -Lilly (Iletiri) U-10, U-20, U-40, 5 cc 328-329 -Lilly (Iletin) U-10, U-20, U-40, U-80, U-100, 10 cc 329 -Mulford 327 -Mulford, 10 Units, 5 cc. ; 20 Units, 5 cc; 40 Units, 5 cc; 10 Units, 10 cc; 20 Units, 10 cc; 40 Units, 10 cc; 80 Units, 10 cc; 100 Units, 10 cc 327 -Squibb 327 -Squibb, 10 Units, 5 cc; 20 Units, 5 cc; 40 Units, 5 cc; 10 Units, 10 cc; 20 Units, 10 cc; 40 Units, 10 cc ; 80 Units, 10 cc; 100 Units, 10 cc 327 -Stearns 328 -Stearns, 10 Units, 5 cc; 20 Units, S cc; 40 Units, 5 cc; 10 Units, 10 cc. ; 20 Units, 10 cc ; 40 Units, 10 cc; 80 Units, 10 cc. ; 100 Units, 10 cc 328 -Toronto 328 -Toronto, 10 Units, 10 cc; 20 Units, 10 cc; 40 Units, 10 cc; 80 Units, 10 cc; 100 Units, 10 cc 328 Intracutaneous Tuberculin for the Mantoux Test (Gilliland) 393 Tuberculin for the Mantoux Test (Lederle) 393 Invert Sugar-Lilly, Solution of 160 Sugar-Lilly, Solution of, 5 Gm. in 10 cc; 6 Gm. in 10 cc; 7.5 Gm. in 10 cc 160 locamfen 248 lodalbin 251 and Mercurol Tablets 251 Capsules, 5 grains 251 lodeikon 210 2.5 Gm. Ampules 210 Capsules-Abbott 210 Iso- 209 Iso-, 2.5 Gm. Ampoules 209 Iodine 248 Compounds 248 Compounds for Intravenous Pyelography-Water-Soluble 261 Compounds for Systemic Use 250 Dusting Powders 249 Preparations Containing Free Iodine 248 Protein Compounds 251 SYz per cent, 2 cc. and 15 cc. Saf-T-Top Tincture (Robert A. Bernhard) 483 U. S. P., 2 cc. and 15 cc, Saf-T-Top Tincture (Robert A. Bern- hard) . 483 Iodized Aliphatic Compounds 252 Fats and Fatty Acids 254 Poppy-Seed Oil, 10 per cent 257 Poppy-Seed Oil, 50 per cent 256 Quinoline Derivatives 260 lodobismitol with Saligenin 142 with Saligenin, Ampules, 2 cc 142 lodo-Casein 252 -Casein Tablets, 5 grains (0.3 Gm.) 252 -Casein with Chocolate, Tablets 252 iodochlorhydroxyquinoline 249 lodophthalein, Soluble 209 lodostarine-Roche 256 -Roche, Chocolate Tablets 256 -Roche, Tablets, 0.25 Gm 256 lopropane 252 lothion 252 Oil 'ri Cum Oleo Theobromatis 301 Tablets Acetarsone-Abbott, 0.25 Gm 93 Acriflavine Hydrochloride-Abbott, 0.03 Gm 199 Acriflavine Xeutral-Calco, ^ grain (tincoated) 200 Alypin, ' 3 grain 54 Aminophylline-Pharmedic, 0.1 Gm 480 Aminophylline-Searle, 0.1 Gm. (1^^ grains) 480 Amytal, Ys grain, ^ grain, ^ grain, IJ^ grains 102 Cebione (Crystals), 0.01 Gm.; 0.05 Gm 457 Cinchophen-Abbott, 5 grains; "J^ grains 168 Chiniofon-Searle, 0.25 Gm. (4 gr.) 164 Chiniofon-Searle Enteric Coated, 0.25 Gm. (4 grains) 164 Chiniofon-Winthrop, 0.25 Gm. (4 grains) 164 Cod Liver Oil Concentrate-Lederle 466 Compounding, j^ grain, Dilaudid Hydrochloride 306 Dial-Ciba, 0.1 Gm. (liA grains) 104 Digalen-Roche ^ cat unit; 1 cat unit 181 Digifoline-Ciba 182 Digitalis Leaves-Squibb, 1 cat unit 180 Digitalis-Squibb, 1 grain 180 Digitalis Whole Leaf-Lederle, 54 grain; IH grains; 3 grains 180 Digitalis Whole Leaf-Lederle, ^ grain; 1^ grains; 3 grains 180 Digitalis-Wilber, 1 J4 grains 180 Dilaudid Hydrochloride, 2.5 mg. (V24 grain) 306 Dubin-Aminophyllin, 0.1 Gm 479 Ephedrine Hydrochloride-Abbott, J4 grain; yi grain 219 Ephedrine Hydrochloride-Squibb, Ys grain; 34 grain 219 Gentian Violet Medicinal-"Xational," 0.0324 (jm. (Yz grain) 213 Gynergen. 0.001 Gm 230 lodo-Casein with Chocolate 252 lodostarine-Roche, 0.25 Gm 256 Lipiodol Calcium-Lafay 257 LipoiodineyCiba, 0.3 Gm. (Uncoated) 258 Methenamine-Calco, 5 grains 237 Metycaine, Yz grain 62 Metycaine, 0.15 Gm 62 Neocinchophen-Lederle, 5 grains 169 Neochinchophen-Squibb, 5 grains 169 Neutral Acriflavine- Abbott, 0.03 Gm. (i^ grain) 200 Neutral Acriflavine-"National," 0.1 Gm. il^A grains) 200 Novocain, 1 grain 69 Novocain, 0.01 Gm. with Suprarenin Synthetic Bitartrate, 0.2 mg. 69 Novocain, Hypodermic, 0.02 Gm. with 1-Suprarenin Synthetic Bitartrate, 0.02 Gm 69 Novocain Hypodermic, 0.2 Gm.; 0.05 Gm 69 Nupercaine-Ciba, 50 mg 64 of Mercurochrome 290 Pernoston, 3 grains 112 Phenobarbital Sodium-Abbott. 0.1 Gm. (1J4 grains) 116 Phenobarbital Sodium-Gane & Ingram, 1^ grains 116 Procaine Borate and Epinephrine 67 1.14 grains (0.07 Gm.) ; 2.28 grains (0.15 Gm.), Procaine Hydro- chloride-Abbott 70 5/3 grain, Procaine Hydrochloride, Hypodermic (Abbott) 70 3 grains. Procaine Hydrochloride, Hypodermic (Abbott) 70 ^ grain. Procaine Hypodermic (Abbott) 70 Procaine Borate without Epinephrine 67 Quinidine Sulphate, 3 Gm., Davies & Rose 350 Sandoptal, 0.2 Gm 116 Scillaren 188 Skiodan, 1 Gm 267 Solargentum, 4.6 grains 427 Stovarsol, 0.25 Gm 93 Suprarenin 223 Synthetic Thyroxine-Roche, 1 mg 443 Theocin, 1 ^ grains 480 Theocin Soluble. 2V2 grains 480 Triturates Sal-Ethvl Carbonate, 1 gr 358 Tuberculin B. E. (P. D. & Co.) 395 Tuberculin T. R.-P. D. & Co 396 GENERAL INDEX 531 Tutocain, 0.03 Gm., 0.1 Gm., 0.05 Gm 71 Tutocain, 0.03 Gm., 0.05 Gm., with Suprarenin, 0.15 mg., 0.06 mg., 0.125 mg 71 Urginin, 0.5 Gm 191 Urginin, Coated, 0.5 Gm 191 Tannic Acid Derivatives 438 Tannigen (Winthrop) 440 Tannin Xucleo-Proteid-Mulford 440 Tannyl Acetate 440 Tartro-Quiniobine 144 -Quiniobine Ampules, 2 cc 145 Tertiary Magnesium Phosphate 281 Testimonials 16 Tests 16 Tetanus Antitoxin Zll Antitoxin (Bovine) (S. & D.) 372 Antitoxin, Bovine 372 Antitoxin Concentartcd (Cutter) 483 Antitoxin, Gilliland's Concentrated and Refined 483 Antitoxin, Globulin-Lederle-^Iodified 378 Antitoxin Globulin (P. D. & Co.) 484 Antitoxin (Hixson Laboratories, Inc.) 483 Antitoxin-N. D. Co 484 Antitoxin (N. Y. C. Dept. Health) 484 Antitoxin (S. & D.) 485 Antitoxin (U. S. S. P. Co.) 485 Antitoxin, Purified (Squibb) 485 -Gas-Gangrene Antitoxin (Combined) (Lilly) 369 -Gas-Gangrene Antitoxin (Combined) (Prophylactic) Refined and Concentrated-P. D. & Co 370 -Gas-Gangrene Antitoxin, "GIobulin-Lederle-Modified" 367 -Gas-Gangrene Antitoxin Mixed-Mulford 369 -Gas-Gangrene Antitoxin (Polyanaerobic Antitoxin, Prophylactic) (Cutter) 367 -Perfringens Antitoxin. Refined and Concentrated (N. D. Co.)... 370 Toxoid, Alum Precipitated 406 Toxoid (Alum Precipitated) Refined (N. D. Co.) 407 Toxoid-Lederle. Refined Alum Precipitated 407 Tetiothalein Sodivim 209 Tetrachlorethvlene 441 -Calco . . ." 441 -Calco, 1 cc 441 Tetrachlormethane 161 Tetraiodophthalein Sodium 209 Tetraiodophenolphthalein Sodium 209 Tetraiodophenolphthalein Sodium Salt-Eastman 210 The Azo Dyes 194 Acridine Dyes 197 Fluorescein (Pyronine) Dyes 202 Triphenylmethane (Rosaniline) Dyes 210 Theobromine and Sodium Acetate-Merck 477 and Sodium Acetate-Roche 477 and Theobromine Compounds 475 -Merck 476 Sodium-Acetate 476 Theocalcin 477 Tablets, 7^ grains 478 Theocin 480 Sodium Acetate 480 Soluble 480 Soluble. 214 grains, Tablets 480 1 y. grains. Tablets 480 Theophylline 480 and Theophylline Compotuids 478 with Ethylenediamine-U. S. P 478 with Sodium Acetate 480 Ther.^peutically Suggestive Names 22 Therapeutic Claims (Comments), Rule 6. — Unwarranted 18 Indications 18 532 GENERAL INDEX Thigenol-Roche 437 Thio-Bismol 139 Ampoules, 0.2 Gm. ; 2 Gm 139 Thiocol-Roche 173 -Roche, Syrup 173 Three CC. Concentrated Solution Liver Extract Parenteral-Lederle. . 318 Thromboplastic Substance, Fibrin Ferments and 232 Local-Lederle 235 Local-Lederle, 20 cc. Vial 235 Local-Squibb 235 Local-Squibb, 20 cc. Vial 236 Local-Squibb, Dental Package, six 4 cc. vials 236 Thymol Iodide 249 Thymol Iodide-Merck 249 Thyroid 336 Desiccated-Lederle 484 Thyroxin 443 (Squibb) 443 Thyroxine 442 Crude 444 -Roche, 1.1 cc. Ampules, Synthetic 443 -Roche, Solution Synthetic 443 -Roche, Synthetic 443 -Roche, 1 mg.. Tablets, Synthetic 443 Tablets, 0.2 mg. ; 0.4 mg. ; 0.8 mg. 2.0 mg. (Squibb) 444 Tincture Digitalis 185 Digitalis Duo-Test McNeil 185 of Digitalis-Mulford. Fat-Free 193 Digitalis, Purified, S. & D 186 Digitalis, Purified, S. & D 485 Digitalis-Wilber 186 Merthiolate, 1 : 1.000 293 Metaphen Saf-T-Top 296 Metaphen, 1:200 295 of Digitalis 185 of Merthiolate, 1 : 1,000, Saf-T-Top 294 Toxin-Antitoxin Mixture 389 -Antitoxin Mixture, Diphtheria 389 -Antitoxin Mixture (Diphtheria Prophylactic) Diphtheria (N. D. Co.) ,.390 -Antitoxin Mixture, Diphtheria Prophylactic, (Goat) Diphtheria (P. D. Co.) 390 -Antitoxin Mixture, 0.1 L-j-, Diphtheria (Gilliland) 390 -Antitoxin Mixture, 0.1 L+, Diphtheria (Hixson Labs.) 390 -Antitoxin Mixture, Diphtheria (0.1 L-f) Diphtheria (Lederle) . . . 390 -Antitoxin Mixture, New Formula (Park-Banzhaf's 0.1 L-f) Diphtheria (S. & D.) 390 -Antitoxin Mixture (New Formula) (Sheep), Squibb, Diphtheria. 391 -Antitoxin Mixture 0.1 L+ Non-Sensitizing (Sheep) Diphtheria (U. S. S. P. Co.) 391 -Antitoxin Mixture, Diphtheria 0.1 L-f (Sheep) Diphtheria (Hixson Labs.) 390 Bacterial 396 Diphtheria, for Schick Test and Control (U. S. S. P. Co.) 420 Diphtheria, Diluted for Schick Test (P. D. & Co.) 420 Diphtheria, for Schick Test, Diluted, Ready for Use-Lilly 419 Diphtheria, for Schick Test, Diluted, Ready for Use-Mulford 420 Diphtheria, for Schick Test in Peptone Solution (Lederle) 419 Diphtheria, for the Schick Test 418 Diphtheria, for Schick Test (Cutter) 418 Diphtheria, for the Schick Test (Diluted) (Cutter) 418 Diphtheria, for the Schick Test (Diluted) (Hixson) 419 Diphtheria, Schick Test, Diluted, Ready for Administration (Gilliland) 419 Diphtheria, for the Schick Test. Diluted with Peptone Solution and Ready for Use (Merrell) 419 Diphtheria, for the Schick Test, Ready to Use without Dilution- Squibb • • • • 420 for Dick Test, Scarlet Fever Streptococcus. P. D. & Co 421 for Dick Test, Scarlet Fever Streptococcus, Squibb 421 GENERAL INDEX 533 for Dick Test, Scarlet Fever Streptococcus (U. S. S. P. Co.) 421 for the Dick Test, Scarlet Fever Streptococcus (Lederle) 421 for the Dick Test, Scarlet Fever Streptococcus, Mulford 421 for the Dick Test, Scarlet Fever Streptococcus, "National" 421 for the Dick Test, Scarlet Fever Streptococcus (U. S. S. P. Co.). 421 for Immunization, Scarlet Fever Streptococcus, Mulford 397 for Immunization, Scarlet Fever Streptococcus, "National" 397 for Immunization, Scarlet Fever Streptococcus, Squibb 397 for Immunization, Scarlet Fever Streptococcus (U. S. S. P. Co.) 397 for Preventative Immunization, Scarlet Fever Streptococcus, P. D. & Co 397 Modified Bacterial 398 Scarlet Fever Streptococcic 396 Scarlet Fever Streptococcic 420 Scarlet Fever Streptococcus. Immunizing (Lederle) 397 (Coley) Erysipelas and Prodigiosus (P. D. & Co.) 417 for Immunity Tests 418 for Immunity Tests 418 Toxoid, Diphtheria 398 Diphtheria, Alum Precipitated (Refined) 401 Diphtheria, Alum Precipitated, Refined (Cutter) 401 Diphtheria, Alum Precipitated (Refined), (Gilliland) 402 Diphtheria, Alum Precipitated (Refined), (Hixson Labs.) 402 Diphtheria, Alum Precipitated (Refined), (Jensen-Salsbery) 402 Diphtheria (Alum Precipitated), Lederle, Refined 403 Diphtheria (Alum Precipitated), Lederle, Refined 403 Diphtheria, Alum Precipitated, Refined (Lee Labs.) 403 Diphtheria, Alum Precipitated (Refined)-Lilly 403 Diphtheria, Alum Percipitated (Refined) (Merrell) 404 Diphtheria, Alum Precipitated (Refined)-P. D. & Co 404 Diphtheria, Alum Precipitated-Squibb, Refined 405 Diphtheria, Alum Precipitated, Refined (U. S. S. P. Co.) 405 Diphtheria, Cutter 398 Diphtheria, Gilliland 398 Diphtheria (Hixson Labs.) 399 Diphtheria (Lederle) 399 Diphtheria (Lilly) 399 Diphtheria (Merrell) 399 Diphtheria (Mulford) 400 Diphtheria (N. D. Co.) 400 Diphtheria (P. D. & Co.) 400 Diphtheria, Squibb 401 Diphtheria, U. S. S. P. Co 401 Staphylococcus 405 Staphylococcus, Lederle 406 Tetanus, Alum Precipitated 406 Tetanus, Alum Precipitated, Refined-Lederle 407 Trademarks, Copyrights (Comments), Rule 9. — Patents 23 "Trade" Names, Proprietary; When Permitted 20 Secrets 15 triacetyl pyrogallol 279 Tribasic Calcium Phosphate 151 Magnesium Phosphate 281 tribromteriarybutylalcohol 145 trichlorbutan-1 164 trichlorbutylidene Glycol 164 Trichlorethylene 52 -Calco 53 -Calco, Tubes, 1 cc 53 Trichloroethylene 52 Triethanolamine-Carbide and Carbon Chemicals Corporation 231 -Technical 230 Trional 438 -trioxy-5-diallylpyrimidin (-2, 4, 6) 103 -5-isobutylallylpyrimidin (2, 4, 6) 116 methylene-Merck (Paraformaldehyde-U. S. P. X.) 484 5-n-butylethlpyrimidin (2, 4, 6) 107 Triphal 240 Amptiles. 0.025 Gm.; 0.1 Gm 240 Trivalent Arsenic, Compounds Containing 80 534 GENERAL INDEX Tropical American Anti-Snake-Bite Serum 371 Tryparsamide 96 Trypsin 177 Trypsin-Armour 178 -Fairchild 178 Group 177 Tuberculin "B. E." (Bacillus Emulsion) (Lederle) 395 B. E. (Concentrated) (P. D. & Co.) 395 B. E. Dried, New 395 B. E., New 394 B. E. (P. D. & Co.), Tablets 395 B. F. (Bovine) (P. D. & Co.) 396 B. F. (Human) (P. D. & Co.) 396 Denys 396 for the Cutaneous Reaction (Pirquet's Reaction) (Cutter) 393 for the Mantoux Test, Intracutaneous (Gilliland) 393 for the Mantoux Test, Intracutaneous (Lederle) 393 for the Mantoux Test (P. D. & Co.) 394 Human Strain Concentrated, Old (Lilly) 393 Intracutaneous for Mantoux Test (N. D. Co.) 394 -Koch 392 Ointment for the Moro Percutaneous Test (Lilly) 393 Ointment in Capsules (for the Moro Percutaneous Diagnostic Test) 393 Old 392 (Old) and Control for the Pirquet Test (P. D. & Co.) 394 Old (Human) (N. D. Co.) 394 "Old" (Koch) (P. D. & Co.) 394 "Old" (Koch's Old Tuberculin) (Lederle) 393 "Old" (O. T.) (Mulford) 394 Old (Tuberculin O. T.) (Cutter) 393 "O. T.", (Old Tuberculin) (Gilliland) 393 "O. T.", Original (Gilliland) 393 Pirquet Test ("O. T.") (Lederle) 393 Residue 395 Residue (Dried) 396 Riickstand 395 Solution for the Von Pirquet Cutaneous Diagnostic Test (Gilliland) 393 T. R. (Concentrated) (P. D. & Co.) 395 T. R. Dried, New 396 T. R. (P. D. & Co.) 395 T. R.-P. D. & Co., Tablets 396 Tuberculine Bouillon Filtre 396 Tuberculinum Denys 396 Novum B. E- 394 Novum B. E. Siccum 395 Novum T. R 395 Novum T. R. Siccum 395 Tuberculins 391 Tuberkelbacillin Rest, Koch 395 Tubes Trichlorethylene-Calco, 1 cc 53 Tutocain 71 Tablets, 0.03 Gm., 0.1 Gm., 0.05 Gm 71 Tablets. 0.03 Gm., 0.05 Gm., with Suprarenin 0.15 mg., 0.06 mg., 0.125 mg 71 Tutocaine Hydrochloride 71 Type I, Antipneumococcic Serum 381 I, Antipneumococcic Serum (Gilliland) 381 I, Antipneumococcic Serum (Mulford) 382 I (Refined and Concentrated), Antipneumococcic Serum-Felton- (N. D. & Co.) 382 I, Antipneumococcic Serum, Refined and Concentrated-Lederle. . . 381 I, Antipneumococcic Serum (Squibb) 382 I, Pneumococcus Antibody Globulin-Mulford 382 II, Antipneumococcic Serum 383 II, Antipneumococcic Serum, refined and Concentrated (Lederle) . 383 GENERAL INDEX 535 Types I and II, Antipneumococcus Serum, Combined 383 I and II, Antipneumococcic Serum, Combined-Mulford 383 I and II, Antipneumococcic Serum, Concentrated (Pneumococcus Antibody Globulin) -Mulford 384 I and II, Antipneumococcic Serum, Concentrated (Squibb) 384 I and II, Antipneumococcic Serum, Refined and Concentrated (N. D. & Co 384 I and II, Antipneumococcic Serum, Refined and Concentrated (Felton) (P. D. & Co.) 384 Typho-Bacterin Mixed (Triple Vaccine) (S. & D.) 415 -Bacterin (Mulford) 413 -Serobacterin-Mulford Mixed (Sensitized Triple Vaccine) 418 -Serobacterin-Mulford (Sensitized Typhoid Vaccine) 417 Typhoid and Typhoid Paratyphoid Vaccines 411 Bacillus, Bacterial Vaccine Made from the 412 Combined Vaccine (Prophylactic) (Lederle) 415 Mixed \'accine, Prophylactic (Lilly) 415 -Paratyphoid Bacterial Vaccine Immunizing (Gilliland) 414 -Paratyphoid Bacterin (Prophylactic) (Abbott) 414 -Paratyphoid Prophylactic (Cutter) 414 -Paratyphoid Vaccine (Prophylactic) (P. D. & Co.) 415 Paratyphoid Vaccine Combined (U. S. S. P. Co.) 416 Prophylactic 412 Prophylactic (Cutter) 412 Vaccine Combined. Immunizing (Squibb) 416 Vaccine (Gilliland) 412 Vaccine (Immunizing) (Squibb) 413 Vaccine (Merrell) 413 Vaccine (N. D. Co.) 413 Vaccine (Prophylactic) (Lederle) 412 Vaccine, Prophylactic (Lilly) 412 Vaccine (Prophylactic) (P. D. ii;: Co.) 413 Vaccine (U. S. S. P. Co.) 413 Ucoline Cod Liver Oil Concentrate 466 Calcium Phosphate Cocoa Wafers 151 Cod Liver Oil Concentrate Tablets 467 Standardized Cod Liver Oil 462 Undulant Fever Bacterial Vaccine (Jensen-Salsberv) 408 Fever Vaccine (N. D. Co.) 409 Unessential Modifications of Official Substances. — Imitations (Comments) 23 Unoriginal Articles, Proprietary Names for 21 Unscientific and Useless Articles. — Rule 10 11 AND Useless Articles (Comments), Rule 10 23 Unv^^arranted Therapeutic Claims (Comments), Rule 6 18 Urea 445 and Ureids, Urethanes (Carbamates) 445 Hydrochloride 0.5 Gm., 1 cc. Ampoule Solution Quinine (U. S. S. P. Co.) 485 Urethanes (Carbamates), Urea and Ureids 445 Urethane with Dial-Ciba, Sterile Ampules, Solution, 1 cc, 2 cc 104 Urginin 190 Coated Tablets, 0.5 Gm 191 Solution 191 Tablets, 0.5 Gm 191 Urotropin 237 Tablets, 5 grains (0.3 Gm.); 7]/. grains (0.5 Gm.) 237 Useless Articles, Unscientific and. — Rule 10 11 Articles (Comments), Rule 10. — Unscientific and 23 Use of Articles for Advertising 18 U. S. P. AND N. F. Products, Modifications of 14 Vaccine, Acne Ba'cillus 407 Acne Bacillus (Cutter) 407 Acne (Lederle) 408 Acne (Squibb) 408 536 GENERAL INDEX Vaccine (Continued) Brucella Melitensis 408 Brucella Melitensis-Lederle 408 Cholera 409 Cholera (Prophylactic) (Lederle) 409 Cholera, Prophylactic (Lilly) 409 Cholera Serobacterin-Mulford, Sensitized Cholera 417 Combined Immunizing, Typhoid (Squibb) 416 (Combined) Staphylococcus (P. D. & Co.) 411 Combined, Typhoid Paratyphoid (U. S. S. P. Co.) 416 (Cumming) Rabies (P. D. & Co.) 388 Furnculosis (P. D. & Co.) 411 (Ghcerinated), Smallpox (Variola) (Squibb) 485 Made From The Typhoid Bacillus, Bacterial 412 Made From The Typhoid Bacillus and the Paratyphoid, "A" and "B" Bacterial 413 Pasteur, Anti-Rabic (Gilliland) 386 Plague Bacillus 409 Plague (Prophylactic) (Lederle) 409 Plague Prophylactic (Lilly) 409 Polyvalent, Acne Serobacterin-Mulford (Sensitized Acne) 417 Rabies 386 Rabies-GiUiland (Sample Method) 386 Rabies (Harris) 387 Rabies (Harris) Lilly 387 Rabies (Hixson) 387 Rabies (Human), (Chloroform Killed) -N. D. Co 388 Rabies (Human), Phenol Killed, (Jensen Salsbery Labs.) 387 Rabies-Lederle (Semple Method) 387 Rabies, (Killed Virus), (Med. Arts Lab.) 388 Rabies, (Killed Virus) Semple (U. S. S. P. Co.) 389 Rabies, (Killed Virus) Squibb (Semple Method) 388 Rabies, (Phenolized) , (Terrell's Labs.) 389 Rabies, (Phenol Killed) -Mulford 388 Rabies (Semple) (Cutter Labs.) 386 Sensitized Staphylococcic (Staphylc-Serobacterin) 417 Sensitized Triple (Typho-Serobacterin-Mulford Mixed) 418 Sensitized Typhoid (Tvpho-Serobacterin-Mulford) 417 Smallpox (Cutter) 483 Smallpox (Gilliland) 483 Smallpox (Lederle) (Preserved with Brilliant Green) 484 Smallpox (Vaccine Virus) Vaccine-N. O. Co 484 (Smallpox Vaccine) Virus (S. & D.) 485 Smallpox (Vaccine Virus) U. S. S. P. Co 485 Staphylococcus 410 Staphylococcus (Albus and Aureus) (Gilliland) 410 Staphylococcus Aureus (Lilly) 411 Staphylococcus Aureus, Polyvalent (Lederle) 411 Staphylococcus (Cutter) 410 Staphylococcus (Lederle) 411 Staphylococcus (Lilly) 411 Staphylococcus (N. D. Co.) 411 Staphylococcus (Squibb) 411 Typhoid Combined (Prophylactic) (Lederle) 415 Typhoid (Gilliland) 412 Typhoid (Immunizing) (Squibb) 413 Typhoid (Merrell) 413 Typhoid Mixed, Prophylactic (Lilly) 415 Typhoid (N. D. Co.) 413 Typhoid-Paratyphoid Immunizing, Bacterial (Gilliland) 414 Typhoid (Prophylactic) (Lederle) 412 Typhoid, Prophylactic (Lilly) 412 Typhoid (Prophylactic) (P. D. & Co.) 413 Typhoid (U. S. S. P. Co.) 413 Undulant Fever Bacterial (Jensen-Salsbery) 408 GENERAL INDEX 537 Undulant Fever (N. D. Co.) 409 Vims (Glycerinated) (P. D. & Co.) 484 Vaccines and Serums 362 Bacterial 407 Mixed Bacterial 416 Vaginal Suppositories Silvol, 5 Per Cent 427 Vehicles and Preservatives 15 Ventriculin 316 100 Gm.; 500 Gm. Bottle 316 10 Gm. Vials 316 Veronal 103 Elixir of 103 Elixir of (Winthrop) 103 -Sodium 120 -Sodium Tablets, 5 grains 120 Tablets. 5 grains 103 Vials Carbarsone, 2 Gm. (31 grains) 94 Concentrated Solution Liver Extract Parenteral-Lederle, 1 cc 318 Lederle Solution Liver Parenteral Refined and Concentrated, 3 cc. 318 Liver Extract-Parke, Davis & Co 315 Vichy, Citratcd, Wagner's Artificial 485 Wagner's Artificial 485 Vioform-Ciba 249 Viosterol, Abbott's A-B-D Extract with Cod Liver Oil and 459 in Halibut Liver Oil (In Capsules), Mead's 470 in Halibut Liver Oil, Mead's 470 in Oil 473 in Oil-Abbott 473 in Oil, Mead's 473 in Oil-Merrell, Sperti Process 474 in Oil. Parke, Davis & Co.'s 474 in Oil-Squibb 474 in Oil, Winthrop 474 with Abbott's Cod Liver Oil 463 with Abbott's Haliver Oil 470 with Cod Liver Oil 462 with Halibut Liver Oil 469 with Halibut Liver Oil-Squibb 470 with Mead's Cod Liver Oil 463 with Mint-Flavored. Squibb Cod Liver Oil 463 with Parke, Davis & Company's Cod Liver Oil 463 with Haliver Oil-Parke-Davis . 370 with Soluble Gelatin Capsules Abbott's Haliver Oil, 3 minims.... 470 with Soluble Gelatin Capsules, Haliver Oil (P. D. & Co.) 470 with Squibb Cod Liver Oil 463 Virus, Vaccine (Glycerinated )-P. D. & Co 484 Viruses, Attenuated Living 386 Vitamin A 448 B 449 C 451 D 452 D Concentrate and Carotene in Oil, Smaco 455 D Concentrate and Carotene in Cod Liver Oil, Smaco 456 D Concentrate in Neutral Oil Capsules, 3 minims., McKesson's Halibut Liver Oil 469 D Concentrate in Neutral Oil, 3 minims. Capsules with I. V. C. Halibut Liver Oil 471 D Concentrate in Neutral Oil with I. V. C. Halibut Liver Oil. .. . 471 D Concentrate in Neutral Oil, 6 cc, with McKesson's Halibut Liver Oil 471 D Concentrate in Oil, Smaco 465 Vitamins And Vitamin Preparations For Prophylactic And Thera- peutic Use 446 Von Pirquet Cutaneous Diagnostic Test, Tuberculin Solution (Gilli- land) 393 Pirquet Test for Tuberculosis (N. D. Co.) 394 538 GENERAL INDEX Wagner's Artificial Vichy 485 Artificial Vichy Citrated 485 Walco Ethylene for Anesthesia 51 Waters, Mineral 22 Water-Soluble Iodine Compounds for Intravenous Pyelography 261 White Mineral Oil 279 White's Cod Liver Oil Concentrate Capsules, 3 minims 466 Cod Liver Oil Concentrate (Liquid) 465 Cod Liver Oil Concentrate Liquid, Vials, 50 cc 466 Cod Liver Oil Concentrate Liquid, Vials, 5 cc 467 Cod Liver Oil Concentrate, Tablets 467 Winthrop Tablets of Salophen, 5 grains 341 Viosterol in Oil 474 Wyeth's Capsules Digitalis Leaf Defatted 180 Xanthine Derivatives 475 Xeroform 134 -S. and G 135 Yellow Mercuric Oxide 300 oxide and Adrenalin Ointment, M. E. S. Co., Compound 301 Precipitate 300 Zinc Compounds 481 Ointment-Lenigallol 279 Permanganate-Merck 482 Permanganate, 1 grain, Mulford 481 Permanganate 481 INDEX TO DISTRIBUTORS Note. — Names of products "Accepted but not described" appear in italics. Abbott Laboratories, North Chicago, Illinois. — Abbott's A-B-D Malt Extract with Cod Liver Oil and Viosterol, 459; Abbott's Cod Liver Oil, 460; Abbott's Cod Liver Oil with Viosterol, 463; Abbott's Haliver Oil, Plain, 468; Abbott's Haliver Oil Plain Capsules, 3 minims, 468; Abbott's Haliver Oil with Viosterol, 470; Acetarsone-Abbott, 93; Acriflavine Hydrochloride-Abbott, 199; Aminopyrine-Abbott, 346; Ampoule Bismuth Subsalicylate with Butyn-D. R. L., 1 cc, 133; Ampoules Dextrose 50%, 20 cc, 50%, 50 cc, 155; Ampoules Ephe- drine Hydrochloride Abbott, 0.05 Cm.. 1 cc. 219; Ampoules Pheno- barbital Sodium (Powder)-Abbott 0.13 Gm., (2 grains), 116; Ampoules Procaine Hydrochloride Solution 10%, 2 cc, 69; Ampoules Procaine Hydrochloride Solution 2%', 5 cc, 69; Ampules Campiodol Emulsion, 20 cc, 255; Ampules Gold Sodium Thiosulfate-Abbott 0.01 Gm.. 0.05 Gm.. 0.1 Gm., 0.25 Gm., 239; Ampules Potassium Bismuth Tartrate (Aqueous) -D. R. L., 2 cc, 138; Ampules Potas- sium Bismuth Tartrate with Butyn-D. R. L., 0.1 Gm., 0.2 Gm., 138; Anesthesin-Abbott, 11; Arbutin-Abbott, 11; Aromatic Chlorazene Pow- der, 246; Argvn. 426; Argvn Tablets, 6 grains, 426; Arsphenamine- D. R. L., 81; Barbital-Abbott, 103; Barbital Sodium-Abbott, 120; Bismarsen. 82; Bismo-Cymol. 130; Bismo-Cymol Ampoules, 1 cc, 2 cc, 130; Bismuth Subsalicylate with Butyn-D. R. L., 60 cc. Bottle, 133; Butesin, 1Z; Butesin Picrate, 73; Butesin Picrate Oint- ment with Metaphen, 74; Butyn. 56; Butyn and Ephedrine Hypo- dermic Tablets, 58; Butyn Solution, 2 per cent, 57; Butyn Tablets, 0.2 Gm. (3 grains), 57; Capsules Ephedrine Hydrochloride-Abbott, Yz grain, 0.0324 Gm. (i^ grain), 219; Capsules Ephedrine Sulfate- Abbott, Yz grain, ^4 grain. Yx grain, 220; Chlorazene, 246; Chlora- zene Surgical Cream. 246; Chlorazene Tablets, 4.6 grains, 246; Chlarcosane-Abbott, 483; Chloriodized Rapeseed Oil. 255; Cincho- phen-Abbott, 168; Concentrated Pollen Extracts-Abbott, 35; Dex- trose-Ringer's Stock Solution Five Times Concentrated-Abbott, 155; Dichloramine-T (Abbott). 247; Digipoten, 192; Digipoten Tablets, 192; Enteric Coated Tablets Neutral Acriflavine-Abbott, 0.03 Gm. HYz grain), 200; Ephedrine-Abbott, 216; Ephedrine Hydrochloride- Abbott, 219; Ephedrine Hydrochloride Solution-Abbott, 3%, 219; Ephedrine Inhalant-Abbott, 216; Ephedrine Sulfate-Abbott, 220; Furunculosis Bacterin-Abbott (Mixed). 410; Gold Sodium Thiosul- fate-Abbott, 239; Halazone- Abbott, 247; lodeikon Capsules-Abbott, 210; Metaphen. 295; Metaphen Solution, 1:500. 1:2,500, 295; Neo- Arsphenamine-D. R. L., 86; Neocinchophen-Abbott, 168; Neocin- chophen-Abbott Tablets, 5 grains, 7^4 grains. 168; Neonal, 107; Neonal Tablets, 0.1 Gm., 107; Neutral Acriflavine-Abbott, 200; Neu- tral Acriflavine-Abbott for Intravenous Injection, 0.1 Gm. Ampules, 200; Neutral Acriflavine Jelly, 1:1,000 Abbott, 200; Opthalmic Ointment Butesin Picrate, 1% and Butesin, 1%, 74; Parresine, 336; Phenobarbital, 114; Phenobarbital Sodium-Abbott, 116; Phenobar- bital Tablets, ^, Y2, W2 grains, 115; Pituitary Solution, 335; Pollen Extracts-Abbott, 45; Pollen Extracts Diagnostic-Abbott, 483; Potas- sium Bismuth Tartrate-D. R. L., 138; Potassium Bismuth Tartrate (Aqueous) -D. R. L., 2.5 per cent, 138; Potassium Bismuth Tartrate with Bucytin-D. R. L., 10 per cent, 138; Procaine-Abbott, 69; Procaine- Epinephrine Ampules, 1 cc, 69; Procaine-Epinephrine Hypodermic Tablets (procaine Yi grain, epinephrine 1/2500 grain; _ procaine _ % grain, epinephrine Visno grain), 70; Procaine-Epinephrine Solution, 100 cc. Bottle, 69; Procaine Hydrochloride-Abbott Tablets. 1.14 grains (0.07 Gm.), 2.28 grains (0.15 Gm.), 70; Procaine Hydro- chloride Hypodermic Tablets, Yi grain, 70; Procaine Hydrochloride Hypodermic Tablets, 3 grains, 70; Procaine Hypodermic Tablets, ->4 grain, 70; Proflavine- Abbott, 201; Soluble Gelatin Capsules 540 INDEX TO DISTRIBUTORS Abbott Laboratories (Continued) Abbott's Haliver Oil with Viosterol, 3 minims. 470; Solution of Epinephrine Hydrochloride, 224; Solution Ephedrine Sulfate-Abbott, 3%, 220; Sterile Ampules of Mercury Oxycyanide, 0.008 Gm., 0.016 Gm., 0.01 Gm., 286; Sterile Ampoules Mercury Salicylate 0.065 Gm. (1 grain), 287; Sterile Ampoules Mercury Succinimide, 0.01 Gm. (% grain), 288; Sterile Ampoules Procaine Hydrochloride Crystals for Spinal Anesthesia, 50 mg., 100 mg.. 120 mg., 150 mg., 200 mg., 70; Sulpharsphenamine-Abbott, 90; Sulpharsphenamine-Abbott, 0.1 Gm., 0.2 Gm., 0.3 Gm., 0.4 Gm., 0.5 Gm., 0.6 Gm.. 0.8 Gm. Ampules, 90; Syrup Ephedrine Hydrochloride- Abbott, 219; Syrup Epinephrine Hydrochloride (Double Strength) -Abbott, 219; Tablets Acriflavine Hydrochloride-Abbott, 0.03 Gm., 199; Tablets Cinchophen- Abbott, 5 grains, 7^ grains, 168; Tablets Ephedrine Hydrochloride- Abbott, ^ grain, ^ grain, 219; Tablets Neutral Acriflavine-Abbott, 0.03 Gm. (pi grain), 200; Tablets Phenobarbital Sodium-Abbott, 0.1 Gm. (1^ grains), 116; Tincture Metaphen, 1:200, 295; Typhoid- Paratyphoid Bacterin (Prophylactic), 414; Viosterol In Oil-Abbott, 473. Aces Laboratory, Inc., Peekskill, New York. — Mercurochrome Supposi- tory Aces, 291. American Antiformin Company, 164-166 Eighth St., Brooklyn, N. Y. — Antiformin (a strongly alkaline solution of sodium hypochlorite), 485. American Hospital Supply Corporation, 1086 Merchandise Mart, Chi- cago, III. — Dextrose in Physiological Sodium Chloride Solution in Vacoliter Container. Sterile,' 2 1-^ %, 5%, 7i^%, 10%, 156-7; Dextrose Solution in Vacoliter Container, Sterile, 2^%, 5%, 7^%, 10%, 20%, 25%, 156; Physiological Sodium Chloride Solution in Vaco- liter Containers, 342; Physiological Sodium Chloride Solution in Half-size Vacoliter Containers, 342. Arlington Chemical Company, Yonkers, N. Y. — Arico Proteins (For Diagnosis), 483; Pollen Extracts-Arlco, 40; Pollen Extract Diag- nostic-Arlco, 483. Armour and Co., Union Stock Yards, Chicago, Illinois. — Concentrated Liver Extract-Armour, 311; Pituitary Liquid (U. S. P.) Armour, 335; Suprarenalin, 223; Suprarenalin Ointment, 223; Suprarenalin Solution, 223; Suprarenalin (Vials), 223; Trypsin-Armour, 178. Baxter, Don, Intravenous Products Corporation (See under Ameri- can Hospital Supply Corporation). Belle Alkali Co., P. O. Box 1371, Charleston, W. Va. — Dichlormethane Solvent, 485. Bernhard, Robt. a., 153 Anderson Ave.. Rochester, N. Y. — Saf-T-Top. 5% Ferric Chloride in 50% Glycerine Solution, 271; Saf-T-Top Isopropyl Alcohol, 98%, 273; Saf-T-Top Mercurochrome, 2 per cent in 25 per cent Glycerine, 291; Saf-T-Top Mercurochrome Solution, 2 per cent, 2 cc, 15 cc, 291; Saf-T-Top Tincture Iodine, S]^ per cent, 2 cc. and 15 cc, 483; Saf-T-Top Tincture Iodine, U. S. P., 2 cc. and 15 cc, 483; Saf-T-Top Tincture of Merthiolate, 1:1,000, 294; Saf-T-Top Tincture Metaphen, 296. Bethlehem Laboratories, Inc., 300 Century Bldg., Bethlehem, Pa.— Hyclorite, 242, INDEX TO DISTRIBUTORS 541 Bilhuber-Knoll Corporation, 154 Ogden Ave., Jersey City, N. J. — Afenil, 150; Ampules Afenil, 150; Ampules Solution Dilaudid Hydrochloride, 2 mg. (1/^2 grain), 1.1 cc, 306; Bromural, 146; Bro- mural Tablets, 5 grains (0.3 Gm.), 146; Dilaudid Hydrochloride, 305; Dilaudid Hydrochloride Compounding Tablets, ^ grain, 306; Dilaudid Hydrochloride Rectal Suppositories. V24 grain, 306; Euresol, 351; Euresol pro Capillis, 351; Hypodermic Tablets Dilaudid Hydrochloride, 2 mg. (%2 grain), 3.2 mg. (1/20 grain), 4 mg. (V16 grain), 306; Hypodermic Tablets Metrazol, ll4 grains, 302; Lenigallol, 279; Lenigallol-Zinc Ointment, 279; Metrazol, 301; Metrazol Ampules, 1 cc, 302; Metrazol Solution, 10 per cent. 302; Metrazol Tablets, 302; Santvl, 360; Santyl Capsules, 6 minims, 361; Tablets Dilaudid Hydrochloride, 2.5 mg. (I/04 grain), 306; Theocalcin Tablets, 7^/2 grains, 478; Theocalcin, 477. BoRCHERDT Malt Extract Cc, 217-221 North Lincoln St., Chicago, 111. — Borcherdt's Malt Extract with Cod Liver Oil, 459. Calco Chemical Co., Inc., Bound Brook, N. J. — Acriflavine Neutral- Calco, 200; Aminoacetic Acid-Calco, 49; Cinchophen-Calco, 168; Cin- chophen-Calco Tablets, 7^^ grains, 168; Coated Tablets Urginin, 0.5 mg., 191; Crystal V'iolet Jellv-Calco, 212; Crystal Violet Medicinal- Calco, 212; Methenamine-Calco. 237; Methylene Blue-Calco, 483; Mcthylthioninc Chloridc-Calco, 483 ; Scarlet Red Medicinal Biebrich- Calco, 195; Solution Urginin, 191: Tablets Acriflavine Neutral- Calco, 200; Tablets Methenamine-Calco, 5 grains, 237; Tablets Urginin, 0.5 mg., 191; Tetrachlorethylene-Calco, 441; Tetrachlor- ethylene-Calco, 1 cc, 441; Trichlorethylene-Calco, 53; Urginin, 190. Campbell Products Co., 79 Madison Ave., New York, N. Y. — Kephrine Hydrochloride, 2"2i\ Kephrine Hydrochloride Bandage, 273; Kephrine Hydrochloride Gauze, 274; Kephrine Hydrochloride Powder, 273; Kephrine Hydrochloride Rectal Suppositories, 27Z. Carbide & Carbon Chemicals Corporation, 30 East 42nd St., New York. — Triethanolamine-Carbide and Carbon Chemicals Corporation, 231. Chappel Bros., Inc., Rockford, 111. — Ampoules Chappel Liver Extract (Subcutaneous), 2.5 cc, 317; Chappel Liver Extract (Oral), 311; Chappel Liver Extract (Subcutaneous), 317. Chemisch-Pharmazeutische a. G., Bad Homburg, Frankfurt-a.-M., Germany. — Quiniobine, 138; Quiniobine Ampules, 2 cc, 139; Tartro- Quiniobine, 144; Tartro-Quiniobine Ampules, 2 cc, 145. Cheney Chemical Co., 2929 East 67th St., Cleveland, Ohio. — Ethylene- Cheney, 51. Cheplin Biological Laboratories, Syracuse, N. Y. — Ampule Solution Procaine Hydrochloride, 2%, 1 cc, 67; Ampule Solution Procaine Hydrochloride, and Epinephrine, 3 cc, 67; Ampules Bismuth Sub- salicylate, 2 grains (0.13 Gm.), in Oil, 1 cc, 134; Ampules Mercury Salicylate, 1 grain (0.065 Gm.), Suspended in Oil, 1 cc, 287; Ampules Solution Dextrose (d-Glucose) U. S. P., 10 Gm., 20 cc ; 25 Gm., 50 cc; 50 Gm., 100 cc; 25 Gm., 50 cc. ; 50 Gm., 100 cc, 157; Ampules Solution Mercury Succinimide, ]/(, grain (0.01 Gm.), 1 cc, 288; Cheplin's B. Acidophilus Milk, 277; Cheplin's Epinephrine Hydrochloride Solution, 224; Cheplin's Epinephrine Hydrochloride Solution, Ampules, 1 cc, 224; Cheplin's Sodium Cacodylate, 0.05 Gm. (54 grain), 1 cc, 94; Cheplin's Sodium Cacodylate, 0.1 Gin. HYz grains); 0.2 Gm. (3 grains); 0.3 Gm. (5 grains); 0.5 Gm. (TYi grains); 1.0 Gm., 1 cc, 95; Cheplin's Sodium Cacodylate, 0.1 Gm. (15}^ grains), 2 cc, 95; Sodium Cacodylate, 94. 542 INDEX TO DISTRIBUTORS Child Welfare Guild, Inc., 386 Fourth Ave., New York, N. Y. — Bite-X, 485. CiBA Company, Inc., 627-633 Greenwich St., New York, N. Y. — Ampules Buffered Solution of Nupercaine-Ciba. 2 cc, 1:200, 64; Ampules Solution of Nupercaine-Ciba, 5 cc; 25 cc. ; 1:1,000, 64; Dial-Ciba, 103; Digifoline-Ciba, 181; Isarol-Ciba, 436; Lipoiodine- Ciba, 258; Lipoiodine-Ciba Diagnostic 10 cc. Bottle, 258; Nupercaine- Ciba. 63; Solution of Nupercaine-Ciba, 2%, 64; Tablets Dial-Ciba, 0.1 Gm. (1^ grains), 104; Tablets Lipoiodine-Ciba, 0.3 Gm. (Uncoated), 258; Tablets Nupercaine-Ciba, 50 mg., 64; Vioform- Ciba, 249. Clinadol Co., Inc., 64 West 14th Street, New York, N. Y.— Clinadol Co.'s Cod Liver Oil Concentrate, 464. Coleman & Bell Company, Norwood, Ohio. — Gentian Violet Improved Medicinal, 213. CoNNAUGHT LABORATORIES, University of Toronto, Toronto 5, Canada. — Insulin-Toronto, 328; Insulin-Toronto, 10 Units, 10 cc. ; 20 Units, 10 cc; 40 Units, 10 cc. ; 80 Units, 10 cc; 100 Units, 10 cc, 328. Cutter Laboratory, 4th and Parker Sts., Berkeley, Calif. — Acne Bacillus Vaccine, 407; Ampoules Solution Silver Nitrate, 1 Per Cent- Cutter, 431; Diphtheria Antitoxin Concentrated, 483; Diphtheria Toxoid-Cutter, 398; Diphtheria Toxoid, Alum Precipitated, Refined, 401; Diphtheria Toxin for the Schick Test, 418; Diphtheria Toxin for the Schick Test, Diluted Ready for Use, 418; Physiological Solu- tion of Sodium Chloride in Saftiflask Containers, 342; Pollen Ex- tracts-Cutter, 41; Pollen Extracts Concentrated-Cutter, 42; Poly- anaerobic Antitoxin, Prophylactic (Tetanus-Gas Gangrene Anti- toxin), 367; Polyanaerobic Antitoxin Therapeutic (Gas Gangrene Antitoxin, 367; Rabies Vaccine (Semple), 386; Smallpox Vaccine, 483; Solution Dextrose-U. S. P., 25 Gm., SO cc ; 50 Gm., 100 cc ; in Bottles, 157; Solution Dextrose-U. S. P., 5%; 10%; in Saftiflask Containers, 157; Solution Dextrose-LT. S. P., 21/2%; 5%; 10%; in Phvsiologic Solution of Sodium Chloride in Saftiflask Containers, 157; Solution Dextrose U. S. P., 20%; 25%; in Fractionally Dis- tilled Water in Saftiflask Container, 157; Staphylococcus Vaccine, 410; Tetanus Antitoxin Concentrated, 483; Tuberculin for the Cutaneous Reaction (Pirquet's Reaction), 393; Tuberculin Old (Tuberculin O. T.), 393; Typhoid Prophylactic, 412; Typhoid- Paratyphoid Prophylactic, 414. Davies, Rose & Co., Ltd., 22 Thayer St., Boston, Mass. — Quinidine Sul- phate (Davies & Rose), 350; Phil. DigitaHs (Davies & Rose), 180; Tablets Quinidine Sulphate, 3 Gm., Davies & Rose, 350. Davis & Geck. Inc., 217 Dufifield St., Brooklyn, N. Y.—Kalmerid Germicidal Tablets Potassium Mercuric Iodide, 297. Diarsenol Co., Inc., 72 Kingsley St., Buffalo, N. Y. — Diarsenol, 82; Diarsenol, 0.1 Gm.; 0.2 Gm.; 0.3 Gm.; 0.4 Gm.; 0.5 Gm.; 0.6 Gm.; 1.0 Gm. ; 2.0 Gm.; 3.0 Gm. Ampules, 82; Neodiarsenol, 87; Neo- diarsenol, 1.5 Gm. ; 1.8 Gm. ; 3 Gm.; 4.5 Gm. Ampoules, 87; Neo- diarsenol, 0.15 Gm.; 0.3 Gm. ; 0.45 Gm.; 0.6 Gm. ; 0.75 Gm.; 0.9 Gm. Ampoules, 87. DuBiN, H. E., Laboratories, Inc., 250 East 43rd St., New York, N. Y.— Ampules Solution Dubin-Aminophyllin, 0.24 Gm., 10 cc. ; 0.48 Gm., 2 cc, 479; Dubin-Aminophyllin, 479; Suppositories Dubin-Amino- phyllin, 0.36 Gm., 479; Tablets Dubin-Aminophyllin, 0.1 Gm., 479. INDEX TO DISTRIBUTORS 543 Eastman Kodak Co., 343 State St., Medical Dept., Rochester, N. Y. — ■ Resorcinol Monoacetate-Eastinan Kodak Co., 351; Tetraiodophenol- phthalein Sodium Salt-Eastman, 210. Fairchild Bros., & Foster, Washington & Laight Sts., New York, N. Y. —Bile Salts-Fairchild, 124; Enzymol, 177; Trypsin-Fairchild, 178. Fougera, E. and Co., Inc., 75 Varick St., New York, N. Y. — Ampoules Lipiodol-Lafay, 1 cc; 2 cc; 3 cc; 5 cc, 257; Capsules Lipiodol- Lafay, 0.5 Gm., 257; Lipiodol-Lafay, 256; Lipiodol Radiologique Ascendant. 257; Lipiodol Radiologique Descendant, 257; Tablets Lipiodol Calcium-Lafay, 257. Gallia Laboratories, Inc., 254-256 West 31st Street, New York, N. Y. — Arheol (Astier), 360; Arheol (Astier) Pearls, 360; Riodine (Astier), 259; Riodine Pearls, 0.2 Gm. (3.1 grains), 259. Gane & Ingram, Inc., 43 West 16th St., New York, N. Y.— Ephedrine Hydrochloride-Gane and Ingram, 219; Ephedrine Sulfate-Gane and Ingram, 220; Phenobarbital U. S. P. (Gane & Ingram), 115; Pheno- barbital Sodium-Gane & Ingram, 116; Tablets Phenobarbital Sodium- Gane and Ingram, 1 J^ grains, 116. GiLLiLAND Laboratories, Inc., Marietta, Pa. — Antimeningococcic Serum, 380; Antipneumococcic Serum Type I, 381; Diphtheria Schick Test Toxin, Diluted Ready for Administration-Gilliland, 419; Diphtheria Toxin-Antitoxin Mixture, 0.1 L-f , 390; Diphtheria Toxoid-Gilliland, 398; Diphtheria Toxoid, Alum Precipitated (Refined), 402; Gilli- land's Concentrated and Refined Diphtheria Antitoxin, 483; Gilli- land's Concentrated and Refined Tetanus Antitoxin, 483; Intra- cutaneous Tuberculin for the Mantoux Test, 393; Normal Horse Serum, 365; Original Tuberculin. "O. T.," 393; Pasteur Anti-Rabic Vaccine, 386; Rabies Vaccine-Gilliland (Semple Method), 386; Scar- let Fever Streptococcus Antitoxin (Refined and Concentrated), 376; Smallpox Vaccine, 483; Staphylococcus Vaccine (Albus and Aureus), 410; Tuberculin "O. T." (Old Tuberculin), 393; Tuberculin Oint- ment in Capsules (for the Moro Percutaneous Diagnostic Test), 393; Tuberculin Solution for the Von Pirquet Cutaneous Diagnostic Test, 393; Tvphoid-Paratyphoid Bacterial Vaccine Immunizing, 414; Typhoid Vaccine, 412. Harris Laboratory, D. L., Metropolitan Bldg., St. Louis, Mo. — Rabies Vaccine (Harris), 387. Hart, E. J. & Co., Ltd., New Orleans, La. — Lac Bismo, 135. Heilkraft Medical Co., 331 Talbot Ave., Boston, Mass. — Dimazon, 196; Dimazon Oil, 196; Dimazon Ointment, 196; Dimazon Powder, 196; Scarlet Red Medicinal-Kalle, 195; Scarlet Red Salve, 195. Heyden Chemical Corporation, SO Union Square, New York, N. Y. — ■ Acetylsalicylic Acid-Heyden, 356; Ichthynat, 434. HiLLE Laboratories, 1791 Howard St., Chicago, Illinois. — Lunosol, 428; Solution Colloidal Mercury Sulphide-Hille, 299. Hixson Laboratories, 22 W. Gay St., Columbus, Ohio. — Diphtheria Antitoxin, 483; Diphtheria Toxin-Antitoxin Mixture, 0.1 L4-, 390; Diphtheria Toxin-Antitoxin Mixture, 0.1 L-f (Sheep), 390; Diph- theria Toxin for the Schick Test (Diluted), 419; Diphtheria Toxoid, 399; Diphtheria Toxoid, Alum Precipitated (Refined), 402; Rabies Vaccine (Hixson), 387; Tetanus Antitoxin, 483. 544 INDEX TO DISTRIBUTORS Hoffmann-LaRoche, Inc., Nutley, N. J. — Alurate, 101; Alurate Tablets, 1 gr., 101; Ampules Scopolamine Stable-Roche, i/^oo grain, 1 cc; Moo grain. 1 cc, 361; Ampuls Synthetic Thyroxine-Roche, 1.1 cc, 443; Betaine Hydrochloride-Roche, 242; Capsules Sodium Alurate, 3^ grains, 117; Chocolate Tablets lodostarine-Roche, 256; Digalen- Roche (Cloetta), 181; Homatropine Hydrochloride-Roche, 99; lodo- starine-Roche, 256; Isacen, 271; Isacen Tablets, 0.005 Gm. (I/12 grain), 272; Larocaine Hydrochloride, 60; Oleo-Bi-Roche, 137; Papaverine Hydrochloride-Roche, 308; Scopolamine Stable-Roche, 361; Sodium Alurate, 117; Solution Synthetic Thyroxine-Roche, 443; Synthetic Thyroxine-Roche, 443; Syrup Thiocol-Roche, 173; Tablets Digalen-Roche, Yz cat; 1 cat unit, 181; Tablets lodostarine-Roche, 0.25 Gm., 256; Tablets Synthetic Thyroxine-Roche, 1 mg., 443; Theobromine and Sodium Acetate-Roche, 477; Thigenol-Roche, 437; Thiocol-Rcche, 173; Thiocol-Roche Tablets, 5 grains, 173. Hollister-Stier Laboratories, 476-481 Paulsen Medical & Dental Bldg., Spokane, Wash. — Pollen Extracts-HoUister-Stier, 43; Protein Extracts Diagnostic-Hollister-Stier, 483. Hospital Liquids, Inc., 843 W. Adams St., Chicago, 111. — Dextrose, 5%; 10%; 25%; in Distilled Water in Filtrair Containers, 158; Dextrose, 5%; 10% in Physiologic Sodium Chloride Solution in Filtrair Container, 158; Physiologic Solution of Sodium Chloride in Filtrair Dispenser, 342; Ringer's Solution, 342; Ringer's Solution in Filtrair Container, 342. Hynson, Westcott & Dunning, Inc., Baltimore, Md. — Ampules Phenol- tetrachlorphthalein. H. W. & D., 207; Ampules Solution Antimony Sodium Thioglycollate, 0.5 per cent, 10 cc; 20 cc, 76; Ampules Solution Antimony Thioglycollamide, 0.4 per cent, 10 cc; 20 cc, 75; Antimony Sodium Thioglycollate, 75; Antimony Thioglycolla- mide, 75; Bromsulphalein-H. W. & D., 204; Enteric Coated Glyco- tauro-H. W. D. Tablets, 125; Glycotauro-H. W. & D., 125; Glyco- tauro-H. W. & D., 5 grains, 125; Glycotauro-H. W. & D. Capsules (half size), 125; Mercurochrome, 289; Mercurochrome, 2 Per Cent Aqueous Solution, 290; Meroxyl, 292; Meroxyl Tablets-H. W & D., 292; Ouabian Ampules-H. W. & D., 186; Phenolsulfonphthalein- H. W. & D., 206; Phenolsulfonphthalein Ampules-H. W. & D., 206; Phenoltetrachlorphthalein-H. W. & D., 206; Sealed Tubes Mercuro- chrome, 0.5 Gm., 290; Solution Bromsulphalein-H. W. & D., 204; Sterile Ampules of Mercury Salicylate-H. W. & D., 1 grain; 1 J/^ grains; 2 grains, 287-8; Surgical Solution of Mercurochrome, 290; Tablets of Mercurochrome, 290. International Vitamin Corp., 50 E. 42nd Street, New York, N. Y.— Capsules, I. V. C. Halibut Liver Oil, Plain, 3 minims., 468; Capsules I. V. C. Halibut Liver Oil with Vitamin D Concentrate in Neutral Oil, 3 minims, 471; I. V. C. Halibut Liver Oil, Plain, 468; I. V. C. Halibut Liver Oil with Vitamin D Concentrate in Neutral Oil, 471. Jensen-Salsbery Laboratories, Inc., 21st & Penn Sts., Kansas City, Mo.- — Diphtheria Toxoid, Alum Precipitated (Refined), 402; Rabies Vaccine (Human), Phenol Killed, 387; Undulant Fever Bacterial Vaccine, 408. Johnson & Johnson, New Brunswick, N. J. — K-Y Lubricating Jelly, 485. Lakeside Laboratories, Inc., 2344 N. Oakland Ave., Milwaukee, Wis. — Ampoules Dextrose (d-Glucose) 10 Gm., 20 cc. ; 25 Gm., 50 cc; 50 Gm., 100 cc, 158; Ampoule Sodium Cacodylate, 0.243 Gm. (3^4^ grains), 5 cc, 95; Ampoule Solution Sodium Cacodylate, 0.19 Gm. (3 grains), 1 cc, 95. INDEX TO DISTRIBUTORS 545 Lederle Laboratories, Inc., Pearl River, N. Y. — Acne Vaccine, 408; Allergenic Extracts-Lederle, 28; Ampule Solution Silver Nitrate, 1 Per Cent-Lederle, 431; Antianthrax Serum, 378; Antipneumococcic Serum, Refined and Concentrated, Type II, 383; Antidysenteric Serum (Polyvalent), 379; Antimeningococcic Serum, 380; Bivalent Antipneumococcic Serum, Refined and Concentrated, 383; Brucella Melitensis Vaccine-Lederle, 408; Cholera Vaccine (Prophylactic), 409; Cod Liver Oil Concentrate Liquid (Lederle), 464; Cod Liver Oil Concentrate Liquid (Lederle) Capsules, 3 minims. 464; Cod Liver Oil Concentrate Liquid (Lederle), Vials, 5 cc, 464; Concen- trated Pollen Antigens-Lederle, 35; Diphtheria Antitoxin, Globulin- Lederle-Modified, 373; Diphtheria Toxin-Antitoxin Mixture (0.1 L-f), 390; Diphtheria Toxin for Schick Test in Peptone Solution, 419; Diphtheria Toxoid, 399; Erysipelas Streptococcus Antitoxin, Globulin-Lederle-AIodified, 374; Ferric Ammonium Citrate-Lederle, Capsules, 0.5 Cm., 484; Gas-Gangrene Antitoxin (Polyvalent) w^ith- out Tetanus Antitoxin, 368; Glycerinatcd Allergenic Extracts-Lederle , 484; Intracutaneous Tuberculin for the Mantoux Test, 393; Liver Extract-Lederle, 313; Neocinchophen-Lederle. 169; Normal Horse Serum, 365; Normal Horse Serum (1: 10 Dilution) for the Con- i'unctival Test, 365; One Cc. Concentrated Solution Liver Extract 'arenteral-Lederle, 317; Plague Vaccine (Prophylactic), 409; Poison Ivy Extract-Lederle (In Almond Oil), 352; Poison Ivy Extract- Lederle (in Almond Oil), 1 cc. 353; Poison Oak Extract-Lederle (in Almond Oil). 352; Poison Oak Extract-Lederle (in Almond Oil). 1 cc, 353; Pollen Antigens-Lederle, 27 \ Pollen Antigens Diagnostic- Lederle, 484; Rabies Vaccine-Lederle (Semple Method), 387; Refined Alum Precipitated Tetanus Toxoid-Lederle, 407; Refined and Con- centrated Antipneumococcic Serum, Type I-Lederle, 381; Refined Diphtheria Toxoid (Alum Precipitated) -Lederle, 403; Scarlet Fever Streptococcus Antitoxin-Globulin-Lederle-Modified, 376; Scarlet Fever Streptococcus Immunizing Toxin, 397; Scarlet Fever Strepto- coccus Toxin for the Dick Test, 421; Schick Test, 419; Smallpox Vaccine (Vaccine Virus), 484; Smallpox Vaccine (Lederle) (Pre- served zvith Brilliant Green), 484; Solution Epinephrine Hydro- chloride-Lederle, 224; Solution Epinephrine Hydrochloride-Lederle (Sterilized), 224; Solution Liver Extract (Lederle) For Oral Use, 312; Staphylococcus Aureus Vaccine, Polyvalent, 411; Staphylo- coccus Toxoid-Lederle, 406; Staphylococcus Vaccine, 411; Tablets Cod Liver Oil Concentrate-Lederle, 466; Tablets Digitalis Whole Leaf-Lederle, V^; ll^; 3 grains. 180; Tablets Neocinchophen-Lederle, 5 grains, 169; Tetanus Antitoxin, Globulin-Lederle-Modified, 378; Tetanus Gas-Gangrene Antitoxin "Globulin-Lederle-Modified," 367; Three Cc. Concentrated Solution Liver Extract Parenteral-Lederle, 318; Thromboplastin Local-Lederle, 235; Thromboplastin Local- Lederle, 20 cc. Vials, 235; Tuberculin "B. E." (Bacillus Emulsion), 395; Tuberculin "Old" (Koch's Old Tuberculin), 393; Tuberculin Pirquet Test ("O. T."), 393; Typhoid Combined Vaccine (Prophy- lactic), 415; Typhoid Vaccine (Prophylactic), 412; Thyroid Desic- cated-Lederle, 484; Vials Concentrated Solution Liver Extract Par- enteral-Lederle, 318; Vials Lederle Solution Liver Extract Parenteral Refined and Concentrated, 3 cc, 318. Lee Laboratories, Columbus, Ohio. — Diphtheria Toxoid, Alum Pre cipitated. Refined, 403. Lilly, Eli. & Co., Indianapolis, Ind. — Ampoule Sodium Amytal, 0.067 Gm. (1 grain); 0.125 Gm. (1^ grains); 0.25 Gm. (3^ grains); 0.5 Gm. (7^ grains); 1.0 Gm. (15 grains), 119; Ampoules Ephedrine Sulfate-Lilly, 1 cc, 0.05 Gm., 220; Ampoules Metvcaine, 1%, 1 cc, 62; Ampoules Metycaine. 2% and Epinephrine (1:25,000), 1 cc, 62; Ampoules Metycaine, 2% and Epinephrine (1:50,000), 2.5 cc, 62; Ampoules Pentobarbital Sodium-Lilly, 0.5 Gm. (7^^^ grains), 112; Ampoules Ouabain 0.0005 Gm. (I/128 grain) -Lilly, 186; Ampoules Solu- tion Dextrose (d-glucose) Lilly, 10 Gm., Buffered, 20 cc; 25 Gm., 50 cc, 158; Ampoules Solution Dextrose (d-glucose) Lilly, 25 Gm., 50 cc; 50 Gm., 100 cc, 158; Ampoules Solution Dextrose (d-glucose) Lilly, Unbuffered, 25 Gm., 50 cc; 50 Gm., 100 cc, 158; Ampoules 546 INDEX TO DISTRIBUTORS Lilly, Eli & Co. (Continued) Solution Liver Extract Concentrated-Lilly, 10 cc, 320; Ampoules Solu- tion Liver Extract-Lilly, 10 cc, 320; Amytal, 102; Antimeningococcic Serum Concentrated, Lilly, 380; Carbarsone, 93; Cholera Vaccine, Prophylactic. 409; Coco-Quinine, 350; Diphtheria Antitoxin-Lilly (Purified, Concentrated), "484; Diphtheria Toxin for Schick Test, Diluted Ready for Use-Lilly, 149; Diphtheria Toxoid, 399; Diphtheria Toxoid, Alum Precipitated (Refined) -Lilly, 403; Elixir Ephedrine Sulfate, 2 grains, 220; Ephedrine-Lilly, 216; Ephedrine Hydro- chloride-Lilly, 219; Ephedrine Sulfate-Lilly, 220; Erysipelas Anti- streptococcic Serum-Lilly, 385; Extralin, 315; Gas Gangrene Anti- toxin (Combined), 369; Hypodermic Tablets Ephedrine Sulfate- Lilly, 0.016 Gm. (14 grain); 0.0325 Gm. (i^ grain), 220; Hypoder- mic Tablets Ephedrine Hydrochloride-Lilly 0.016 Gm. (^ grain); 0.0325 Gm. (^ grain), 219; Hypodermic Tablets Strophanthin Vioo grain-Lilly, 192; Iletin (Insulin-Lilly), 328; Iletin (Insulin- Lilly) U-10, 5 cc; U-20, 5 cc; U-40, 5 cc; U-10, 10 cc; U-20, 10 cc. ; U-80, 10 cc; U-100, 10 cc, 328-9; Inhalant Ephedrine Com- pound-Lilly, 216; Inhalant Ephedrine (Plain) -Lilly, 216; Lilly's Ephedrine Jelly, 220; Liver Extract-Lillv, 314; Liver Extract-Lilly, 110 Gm. Bottle. 314; Liver Extract-Lilly. Vials, 314; Lubricating Jellv, 485; Merthiolate, 293; Merthiolate Jelly 1:1,000, 293; Mer- thiolate Ointment, 1:2,000, 293; Merthiolate Ophthalmic Ointment, 1:5,000, 293; Merthiolate Solution, 1:1,000, 293; Metycaine. 61; Metycaine Ophthalmic Ointment, 4 per cent, 62; Normal Horse Serum, 365; Ointment Ephedrine Compound, 216; Old Tuberculin, Human Strain Concentrated, 393; Oridine, 258; Oridine Tablets, 259; Parathyroid Extract-Lillv, 331; Parathyroid Extract-Lilly, 1 cc. Ampuls. 331; Parathvroid Extract-Lilly, 5 cc. Vial, 331; Pentobar- bital-Sodium-Lillv, 112; Pirquet Test, 393; Pituitary Extract-Lilly- U. S. P.. 335; 'Plague Vaccine, Prophylactic, 409; Pulvules Car- barsone, 0.25 Gm. (334 grains), 94; Pulvules Ephedrine Hydro- chloride-Lilly, 0.025 Gm. (5^ grain); 0.05 Gm. (54 grain), 219; Pulvules Ephedrine Sulfate-Lilly. 0.025 Gm.; 0.05 Gm., 220; Pul- vules Extralin. 0.5 Gm., 316; Pulvules Pentobarbital-Sodium-Lilly, \y2 grains, 112; Pulvules Sodium Amytal, 1; 3 grains, 119; Rabies Vaccine ( Harris) -Lillv, 387; Smallpox Vaccine, 484; Sodium Amytal, 118; Solution Ephedrine Hydrochloride-Lilly, 3%, 219; Syrup Ephedrine Hydrochloride, 219; Solution Ephedrine Sulfate-Lilly, 3%, 220; Solution of Invert Sugar-Lilly, 160; Solution of Invert Sugar-Lilly, 5 Gm. in 10 cc; 6 Gm. in 10 cc. ; 7.5 Gm. in 10 cc, 160; Solution Liver Extract-Lilly, 320; Solution Liver Extract Con- centrated-Lilly, 319; Solution Metycaine, 2%, 62; Staphylococcus Aureus Vaccine, 411; Staphylococcus Vaccine, 411; Syrup Ephedrine Sulfate (0.22 Gm. in 100 cc. ; 0.44 Gm. in 100 cc), 220; Tablets Amytal, %; J4 ; M; 1/4 grains, 102; Tablets Metycaine, 0.15 Gm., Yi grain. 62; Tetanus Antitoxin, 484; Tincture Merthiolate. 1:1,000. 293; Tuberculin Ointment for the Moro Percutaneous Test, 393; Typhoid Mixed Vaccine, Prophylactic, 415; Typhoid Vaccine, Prophy- lactic, 412; Vials Carbarsone, 2 Gm. (31 grains), 94. LiVERMEAL Corp., 1006 Clinton St., Hoboken, N. J. — Liver Meal, 315. McCoRMicK & Co., Inc., Light, Barre & Charles Sts., Baltimore, Md. — McCorniick's English Mustard, 484. McKesson & Robbins, Inc., Bridgeport, Conn. — McKesson's Halibut Liver Oil Plain, 11 cc, 468; McKesson's Halibut Liver Oil Plain, Capsules, 3 minims, 468; McKesson's Halibut Liver Oil v^ith Vita- min D Concentrate in Neutral Oil, Capsules, 3 minims, 469; McKes- son's Halibut Liver Oil with Vitamin D Concentrate in Neutral Oil, 6 cc, 471. McNeil Laboratories, Inc., 2900 N. Seventeenth St., Philadelphia, Pa. — Capsules Digitalis Duo-Test McNeil, 180; Lubricant-McNeil, 485; McNeil's Emulsion of Castor Oil (Emulsion Olei Ricini-McNeil's), 162; Tincture Digitalis Duo-Test-McNeil, 185. INDEX TO DISTRIBUTORS 547 Mallinckrodt Chemical Works, Second and Mallinckrodt Sts.. St. Louis, Mo. — Acetylsalicylic Acid-Mallinckrodt, 356; Arsphenamine- Mallinckrodt, 81; Barbital-Mallinckrodt, 103; Barium Sulfate Pure- Mallinckrodt, 121; Cinchophen-Mallinckrodt, 168; Copper Citrate- Mallinckrodt. 170; Hippuran, 263; Hippuran (Crystals), 12 Cm. vial, 264; lodeikon, 210; lodeikon. 3.5 Gm. Ampules, 210; Iso- lodeikon, 209; Iso-Iodeikon, 2.5 Gm. Ampoules. 209; Mercuric Cyanide-Mallinckrodt, 286; Neoarsphenamine-Mallinckrodt, 86; P'henobarbital Sodium-Mallinckrodt, 116; Quinidine-Mallinckrodt. 349; Quinine Ethyl Carbonate-Mallinckrodt, 351; Sodium Acid Phosphate (Monobasic)-Mallinckrodt, 484; Sterile Solution Hippuran, 25 cc. size, 264; Sulpharsphenamine-Mallinckrodt, 91; Sulpharsphen- amine-Mallinckrodt, 0.1 Gm. ; 0.2 Gm.; 0.3 Gm.; 0.4 Gm.; 0.5 Gm. ; 0.6 Gm. Ampules, 91. Maltbie Chemical Co., 246-250 High St., Newark, N. J.— Calcreose, 171; Calcreose Tablets, 4 grains, 171; Compound Syrup of Calcreose, 171; Ephedrine Nasal Jelly-Maltbie, 220; Solution Calcreose, 171. M.^LTiNE Company, 8th Ave. and 18th St., Brooklyn, N. Y. — Maltine with Cod Liver Oil, 459; Maltine with Cod Liver Oil and Iron iodide, 459; Maltine with ]\Iineral Oil and Cascara Sagrada, 279. Manhattan Eye Salve Co., Inc.. Louisville, Ky. — Butyn Ointment-M. E. S. Co., 58; Compound Yellow Oxide and Adrenalin Ointment- M. E. S. Co., 301; Copper Citrate Ointment (5 per cent); (10 per cent)-M. E. S. Co., 169; Holocaine and Adrenalin Ointment-M. E. S. Co., 65; Holocaine Ointment-M. E. S. Co., 65. Mead Johnson & Co., Evansville, Ind. — Mead's Cod Liver Oil Fortified with Percomorph Liver Oil, 460; Mead's Cod Liver Oil -with Viosterol, 463; Mead's Halibut Liver Oil, 469; Mead's Oleum Percomorphym, 472; Mead's Oleum Percomorphym, 50% (In Capsules), 472; Mead's Standardized Cod Liver Oil. 460; Mead's Standardized (I^od Liver Oil, Flavored, 460; Mead's Viosterol in Halibut Liver Oil, 470; Mead's Viosterol in Halibut Liver Oil, (in capsules), 470; Mead's \"iolsterol in Oil, 473. Medical Arts Laboratory, Oklahoma City, Okla. — Rabies Vaccine (Killed Virus), 388. Merax, Inc., 1341 Hawthorn Ave., Portland, Oregon. — Merax Mercury Cyanide Solution, 485. Merck & Co., Rahway, N. J. — Agar Agar, 25; Agar Agar Powder, 25; Agar Agar Shreds, 25; Aminopyrine-Merck, 346; Ampules Cebione (Crystals), 0.1 Gm., 457; Ampuls Gold Sodium Thiosulfate-Merck, 0.01 Gm.; 0.025 Gm.; 0.05 Gm.; 0.10 Gm.; 0.20 Gm. ; 0.25 Gm. ; 0.30 Gm.; 0.50 Gm. and 1.0 Gm, 240; Arbutin-Merck, 77; Ars- phenamine-Merck, 82; Arsphenamine-Merck, 0.1 Gm.; 0.2 Gm. ; 0.3 Gm.; 0.4 Gm.; 0.5 Gm. ; 0.6 Gm. Ampules, 82; Aminoacetic Acid- Merck, 49; Barbital-Merck, 103; Barbital Sodium-Merck, 120; Barium-Sulphate-Merck for X-Ray Diagnosis, 121; Benzene (Ben- zol) -Merck Reagent, Thiophen Free, 122; Betanaphthol Benzoate- Merck, 303; Bismosol, 131; Bismosol Ampules, 1 cc, 131; Bismuth Betanaphthol-Merck, 132; Bismuth Subsalicylate-Merck, 134; Butyl- Chloral Hydrate-Merck, 165; Calcium Gluconate-Merck, 151; Calcium Phosphate Tribasic-Merck, 152; Cebione, 457; Chlorbutanol (Anhy- drous)-Merck, 165; Chlorbutanol (Hydrous)-Merck, 165; Creosote- Merck, 484; Digitan, 192; Digitan Ampules (for Hypodermic Use), 193; Digitan Tablets, IH grains (0.1 Gm.). 193; Digitan Tincture, 193; Digitoxin-Merck, 185; Ephedrine Alkaloid-Merck, 218; Ephedrine Hydrochloride-Merck, 219; Ephedrine Sulfate-Merck. 221; Erythol 548 INDEX TO DISTRIBUTORS Merck & Co. (Continued) Tetranitrate (Undiluted). 304; Erythol Tetranitrate Tablets-Merck, J^ ; % grain, 304; Fluorescein-Merck, 203; Formin, 237; Formin Tablets, 5 grains (0.3 Gm.); 7^ grains (0.5 Gm.), 237; Gold Sodium Thio- sulfate-Merck, 240; Guaiacol Carbonate-Merck, 484; Homatropine Hydrochloride-Merck, 99; Ichthyol, 436; Iron Lactate-Merck, 270; Kelene, 50; Liquid Petrolatum-Merck, 280; Magnesium Phosphate Tribasic-Merck. 282; Mercury Cyanide-Merck, 286; Mercury Succinimide-Merck, 288; Neocinchophen-Merck, 169; Neoarsphen- amine-Merck, 86; Neoarsphenamine-Merck, 0.15 Gm. ; 0.3 Gm. ; 0.45 Gm.; 1.6 Gm.; 0.75 Gm.; 0.9 Gm. Ampules, 86; Ouabain-Merck (G. Strophanthin), 187; Papaverine Hydrochloride-Merck. 308; Pheno- barbital-Merck. 115; Phenobarbital Sodium-Merck, 116; Procaine Hydrochloride-Merck, 70; Quinidine-Merck, 349; Quinidine Sul- phate-Merck. 350; Quinine Ethyl Carbonate-Merck, 351; Scarlet Red Medicinal Biebrich-Merck, 195; Silver Lactate-Merck. 430; Sodium BiophospJiate-Merck, 484; Sodium Peroxide-Merck, 340; Stovarsol, 93; Stovarsol Tablets, 0.25 Gm., 93; Sulpharsphenamine-Merck, 91; Sulpharsphenamine-Merck, 0.1 Gm.; 0.2 Gm. ; 0.3 Gm. ; 0.4 Gm. ; 0.5 Gm.; 0.6 Gm. Ampules, 91; Tablets Cibione (crystals), 0.01 Gm.; 0.05 Gm., 457; Theobromine-Merck. 476; Theobromine and Sodium Acetate-Merck, 477; Thymol Iodide-Merck, 249; Trioxymethvlene- Merck (Parafarmaldchyde-U. S. P. X), 484; Tryparsamide, 96; Urea- Merck, 445; Zinc Permanganate-Merck, 482. Merrell Co., Wm. S., Cincinnati, Ohio. — Acid SaUcylate-Merrcll, 484; Ampoules Solution Dextrose. 50%, 20 cc. ; 50%, 50 cc, 158; Dio- thane Hydrochloride, 58; Diphtheria Toxin for the Schick Test, Diluted with Peptone Solution and Ready for Use, 419; Diphtheria Toxoid, 399; Diphtheria Toxoid, Alum Precipitated (Refined), 404; Fibrinogen Local-Merrell, 234; Fibragan Local-Merrell, 7 cc. Vials, 234: Natural Oil of Sweet Birch-Merrell, 484; Pituitary Extract-U. S. P.-Merrell, 335; Sodium Salicylate-Merrell, 484; Typhoid Vaccine, 413; Viosterol in Oil, Merrell, Sperti Process, 474. Miller. E. S. Laboratories, Inc., 743 Maple Avenue, Los Angeles, Calif. — Ampoule Sterile Solution Dextrose, U. S. P., 50 Gm., 10 cc; 10 Gm., 20 cc; 25 Gm., 50 cc; 50 Gm., 100 cc, 159; Ampoule-Vial Sterile Solution Dextrose, U. S. P., 10 Gm., 20 cc. ; 25 Gm., 50 cc; 50 Gm., 100 cc, 159. Monsanto Chemical Company, St. Louis, Mo. — Acetylsalicylic Acid (Aspirin) -Monsanto, 356; Chloramine-T (Monsanto), 246; Chlorco- sane-Monsanto, 484; Dichloramine-T (Monsanto), 247; Halazone- Monsanto, 247. Mulford Colloid Laboratories, 38 & Ludlow Sts., Philadelphia, Pa. — Rhus Tox. Antigen-Strickler. 353; Rhus Tox. Antigen-Strickler (four 1 cc. vials), 353; Rhus Venenata Antigen-Strickler, 354; Rhus Venanata Antigen-Strickler (four 1 cc. vials), 354. National Aniline & Chemical Company, 40 Rector St., New York. — Acriflavine-"National," 199; Enteric Coated Tablets Gentian Violet Medicinal-"National," 0.0324 Gm. (^ grain), 213; Enteric Coated Tablets Neutral Acriflavine-"National," 0.0324 Gm. (>^ grain), 200; Gentian Violet Medicinal-"National," 213; Neutral Acriflavine- "National," 200; Neutral Acriflavine-"National" "Pro Injectione," 0.5 Gm.; 1.0 Gm., Vials, 200; Neutral Acriflavine-"National," Troches, 200; Ointment Neutral Acriflavine-"National," 1 per cent, 200; Proflavine-"National,-'' 201; Scarlet Red Medicinal-"National," 196; Tablets Gentian Violet Medicinal "National," 0.0324 Gm. (^ grain), 213; Tablets Neutral Acriflavine-"National," 0.1 Gm. (1^ grains), 200. INDEX TO DISTRIBUTORS 549 National Drug Company, 4679-85 Stenton Ave., Philadelphia, Penna. — Ampul Solution of Dextrose, 10 Gm., 20 cc. ; 25 Gm., 50 cc., 159; Ampul-Vial Solution of Dextrose, 25 Gm., 50 cc.; 50 Gm., 100 cc. ; 159; Antimeningococcic Serum, 380; Antipneumococcic Serum- Felton- Type I (Refined and Concentrated), 382; Antipneumococcic Serum, Types I and II, Refined and Concentrated, 384; Diphtheria Antitoxin, 484; Diphtheria Toxin-Antitoxin Mixture (Diphtheria Prophylactic), 390; Diphtheria Toxoid, 400; Erysipelas Antistrepto- coccus Serum, 385; Gas Gangrene Antitoxin Refined and Concen- trated (CI. Perfringens. CI. Septique Antitoxin), 369; Normal Horse Serum, 366; Ointment Scarlet Red Biebrich, 8 per cent, 195; Pollen Antigens "National," 39; Pollen Extracts Diagnostic, 484; Rabies Vaccine (Human), (Chloroform Killed)-N. D. Co., 388; Refined Diph- theria Toxoid (Alum Precipitated), 404; Refined Tetanus Toxoid (Alum Precipitated), 407; Scarlet Fever Streptococcus Antitoxin Refined and Concentratcd-"National," 377; Scarlet Fever Streptococ- cus Toxin for the Dick Test-"National," 421; Scarlet Fever Strepto- coccus Toxin for Immunization-"National," 397; Schick Test, Peptone Diluent, 420; Smallpox Vaccine (Vaccine Virus), 484; Staphylo- coccus Vaccine, 411; Tetanus Antitoxin, 484; Tetanus-Perfringens Antitoxin, Refined and Concentrated, 370; Tuberculin Intracutaneous for Mantoux Test, 394; Tuberculin Old (Human), 394; Typhoid Vaccine, 413; Undulant Fever Vaccine, 409; Von Pirquet Test for Tuberculosis, 394. National Milk Sugar Co., Inc., 350 Madison Ave., New York, N. Y. — Beta-Lactose, 153. New York City Department of Health, Bureau of Laboratories, N. Y., N. Y. — Diphtheria Antitoxin (Globulin), 484; Tetanus Anti- toxin, 484. Ohio Chemical & Manufacturing Co., 1177-1199 Marquette St. N. E.. Cleveland, Ohio. — Ohio Carbon Tetrachloride Compound, 485; Ohio Ethylene, 51. Parke, Davis & Co., Detroit, Mich. — Adrenalin, 222; Adrenalin Chloride Solution, 222; Adrenalin Inhalant, 222; Adrenalin Ointment, 222; Adrenalin Suppositories, 222; Adrenalin Tablets, %oo grain; 1/200 grain, 222; Adrenalin and Chloretone Ointment, 222; Adrenalin and Cocaine Tablets, 222; Ampoules Adrenalin Chloride Solution 1: 10,000, 1 cc; 1: 2,600, 1 cc; 1: 1,000, 1 cc, 223; Ampoules Ergot Aseptic, 1 cc, 228; Ampoules Iron Citrate Green-P. D. & Co., yi; M; 1^ grains, 270; Ampoules Mapharsen, 0.04 Gm. ; 0.06 Gm.; 0.4 Gm.; 0.6 Gm., 84; Ampoules of Pitocin, 334; Ampoules of Pitocin, 0.5 cc; 1 cc, 334; Ampoules of Pitressin, 334; Ampoules of Pitres- sin, 1 cc, 334; Ampoules Pituitrin, 0.5 cc. ; 1 cc, 336; Ampoules Thio-Bismol, 0.2 Gm. ; 2 Gm., 139; Antianthrax Serum, 378; Anti- dysenteric Serum, 379; Antimeningococcic Serum, 380; Antipneu- mococcic Serum (Felton) Type I, 382; Antipneumococcic Serum (Felton) Types I and II Refined and Concentrated, 384; Apothesine, 54; Apothesine Hypodermic Tablets, 0.08 Gm. (1^4 grains), 55; Apothesine Solution, 55; Apothesine and Adrenalin Hypodermic Tablets (Apothesine Ys grains, Adrenalin V1600 grain; Apothesine AYs grains, Adrenalin V^oo grain), 55; Bismuth Paste Surgical-P. D. & Co., 133; Bismuth Salicylate in Oil-P. D. & Co., 2 ounce bottle, 134; Boro-Chloretone, 165; Brometone. 145; Brometone Capsules, 5 grains, 146; Capsules Carbon Tetrachloride (For Human Use) -P. D. & Co., 20 minims, 161; Capsules Ephedrine Hydrochloride- P. D. & Co., Yi grain; Ya- grain, 219; Capsules Ephedrine Sulfate-P. D. & Co., 0.025 Gm. (^ grain); 0.05 Gm. (3/^ grain), 221; Capsules Neo- silvol, 6 grains, 430; Capsules Ortal Sodium, Ya- grain (0.05 Gm.); 3 grains (0.2 Gm.) ; 5 grains (0.3 Gm.), 109; Capsules Silvol, 6 grains, 427; Capsules Solution Silver Nitrate, 1 Per Cent-P. D. & Co., 6 minims. 431; Chloretone, 165; Chloretone Capsules, 3 grains; 5 grains, 165; Chloretone Inhalant, 165; Compressed Tablets Sal-Ethyl Carbonate, 5 grs., 358; Compressed Tablets Sal-Ethyl Carbonate with 550 INDEX TO DISTRIBUTORS Parke, Davis & Co. (Continued) Aminopyrine, 358; Compressed Tablets Sal-Ethyl Carbonate with Phenacetin, 358; Diphtheria Antitoxin (Concentrated Antidiphtheric Serum Globulin), 484; Diphtheria Toxin- Antitoxin Mixture, New- Formula (Park-Banzhaf's 0.1 L-f), 390; Diphtheria Toxin Diluted for Schick Test, 420; Diphtheria Toxoid, 400; Diphtheria Toxoid, Alum Precipitated (Refined)-P. D. Co., 404; Ephedrine Hydro- chloride-P. D. & Co., 219; Ephedrine Sulfate-P. D. & Co., 221; Ergot Aseptic, 228; Erysipelas and Prodigiosus Toxins (Coley). 417; Erysipelas Streptococcus Antitoxin Refined and Concentrated- P. D. & Co., 374; Furunculosis Vaccine, 411; Gas-Gangrene Antitoxin (Combined) Retined and Concentrated- P. D & Co., 370; Germicidal Discs of Potassio-Mercuric lodide-P. D. & Co., 1^; ^ grains, 297; Glaseptic Ampoules Ephedrine Sulfate-P. D. & Co., 0.05 Gm. (M grain), 1 cc. 221; Glaseptic Ampoules Mercury Salicylate- P. D. & Co., 0.065 Gm. (1 grain); 0.13 Gm. (2 grains), 287; Glaseptic Ampoules Mercury Succinimide-P. D. & Co., 0.01 Gm, (i/^ grain), 288; Glaseptic Ampoules Sodium Cacodylate-P. D. & Co., 0.2 Gm. (3 grains); 0.3 Gm. (5 grains); 0.45 Gm. (7 grains); 0.1 Gm. (II/2 grains); 0.13 Gm. (2 grains), 1 cc. 95; Glaseptic Ampoules Sodium Cacodylate-P. D. & Co., 1 Gm. (15^ grains), 2 cc, 95; Glaseptic Ampoules Solution Dextrose, U. S. P., 50%, 20 cc; 50 per cent, 50 cc; 50 per cent, 100 cc, 159; Glaseptic Ampoules Solution Liver Extract-P. D. & Co. (Intramuscular), 2 cc, 319; Glaseptic Ampules Bismuth Salicylate in Oil-P. D. & Co.. 1 cc, 134; Group Protein Extracts-Diagnostic-P. D. & Co., 484; lodalbin, 251; lodalbin Cap- sules, 5 grains, 251; lodalbin and Mercurol Tablets, 251; Iron Citrate Green-P. D. & Co., 270; Kapseals Ortal Sodium with Aminopyrine, 109; Kapseals Ortal Sodium with Phenacetin, 110; Liver Extract- Parke, Davis & Co., 314; Liver Extract (Intramuscular)-Parke, Davis & Co., 319; Malt Extract with Cod Liver Oil- P. D. & Co., 461; Mapharsen, 84; Meningococcus Antitoxin-P. D. & Co., 375; Mer- curettes-P. D. & Co., 301; Mercurol, 291; Neo-Silvol, 429; Neo- Silvol Ointment, 5 Per Cent, 430; Neo-Silvol Vaginal Suppositories, 430; Normal Horse Serum-P. D. & Co., 366; Ortal-Sodium. 109; Parke, Davis & Company's Cod Liver Oil with Viosterol, 463; Parke- Davis Haliver Oil, Plain, 469; Parke-Davis Haliver Oil with Viosterol, 470; Parke, Davis & Companv Standardized Cod Liver Oil. 460; Parke. Davis & Co.'s Viosterol in Oil, 474; Paroidin, 331; Paroidin, 5 cc. Vials, 331; Pituitrin, 335; Proposote, 172; Proposote Capsules, 5 minims; 10 minims, 173; Protein Extracts Diagnostic- P. D. & Co., 484; Rabies Vaccine (Gumming), 388; Sal-Ethyl, 357; Sal-Ethyl Capsules, 5 minims, 357; Sal-Ethyl Carbonate, 358; Scar- let Fever Streptococcus Antitoxin-P. D. & Co., 377; Scarlet Fever Streptococcus Toxin for Dick Test-P. D. & Co., 421; Scarlet Fever Streptococcus Toxin for Preventive Immunization-P. D. & Co., 397; Scarlet Red Emulsion, 4 per cent-P. D. & Co., 196; Scarlet Red Ointment, 5 per cent; 10 per cent-P. D. & Co., 196; Scarlet Red Sulfonate, 196; Silvol, 427; Silvol Bougies. 5 Per Cent, 427; Silvol Ointment, 5 Per Cent, 427; Soluble Gelatine Capsules Parke-Davis Haliver 0'\\, Plain, 3 minims, 469; Soluble Gelatin Capsules Haliver Oil with Viosterol, 470; Soluble Gelatin Capsules Parke, Davis & Company's Standardized Cod Liver Oil, 10 minims, 20 minims, 2.5 Gm., and 5 Gm., 461; Solution Ephedrine Sulfate-P. D. & Co., 3%, 221; Staphylococcus Vaccine (Combined), 411; Stearodine, 259; Stearodine Tablets, 260; Tablet Triturates Sal-Ethyl Carbonate, 1 gr.. 358; Tablets Tuberculin B. E.-P. D. & Co., 395; Tablets Tuber- culin T. R.-P. D. & Co., 396; Tetanus Antitoxin Globulin. 484; Tetanus-Gas-Gangrene Antitoxin (Combined) (Prophylactic) Refined and Concentrated-P. D. & Co., 370; Thio-Bismol, 139; Tuberculin B. E. (Concentrated), 395; Tuberculin B. F. (Bovine), 396; Tuber- culin B. F. (Human), 396; Tuberculin "Old" (Koch), 394; Tuber- culin (Old) and Control for the Pirquet Test, 394; Tuberculin T. R. (Concentrated), 395; Tuberculin for the Mantoux Test, 394; Typhoid-Paratyphoid Vaccine (Prophylactic), 415; Typhoid Vaccine (Prophylactic), 413; Vaccine Virus (Glycerinated), 484; Vaginal Suppositories Silvol, 5 Per Cent, 427; Ventriculin, 316; Ventriculin, 10 Gm. Vials, 316; Ventriculin, 100 Gm.; 500 Gm. Bottle, 316; Vials Liver Extract-Parke, Davis & Co., 315. INDEX TO DISTRIBUTORS 551 Patch, E. L., Co., Stoneham Postoffice, Boston, Mass. — Patch's Flavored Cod Liver Oil, 461. Petrolagar Laboratories, 8134 McCormick Blvd., Chicago, Illinois. — Petrolagar, 280; Petrolagar (Unsweetened), 280; Petrolagar with Cascara (Non-Bitter), 280; Petrolagar (with Milk of Magnesia), 280; Petrolagar (with Phenolphthalein), 280. Pfanstiehl Chemcial Co., 104 Lake View Ave., Waukegan, 111. — Amino-Acid-Pfanstiehl, 49. Pfizer, Chas. & Co., Ixc, 11 Bartlett St., Borough of Brooklyn, N. Y. — Calcium Gluconate-Pfizer, 151; Cinchophen-Pfizer, 168. Pharmedic Corporation, 160 East 127 St., New York, N. Y. — Amino- phylline-Pharmedic, 480; Amoules Solution Aminophylline-Phar- medic. 0.24 Gm., 10 cc. ; 0.48 Cm., 2 cc, 480; Suppositories Amino- phvUine-Pharmedic, 0.36 Gm., 480; Tablets Aminophylline-Phar- medic, 0.1 Gm., 480. Pitman-Moore Company, Indianapolis, Ind. — Siomine, 253; Siomine Capsules, J/^, 1; 2; 5 grains, 253. Plant Products Co., 1605 Guarantee Title Bldg., Cleveland, Ohio. — Plant's Magnesia Wafers, 280. Prophyl.\cto Manufacturing Co., 25 E. Washington St., Chicago, 111. — Pemco Menthol Eucalyptus Compound Nasal Spray, 282. Puritan Compressed Gas Corporation, 2012 Grand Ave., Kansas City. — Ethylene (Puritan Compressed Gas Corp.), 51. Reinschild Chemical Co.. 18 Grand Street. New Rochelle, N. Y. — ■ Agar Agar Shreds, 25; Phenolphthalein-Agar, 25. Richards Pharmacal Co., Inc., 2 and 4 Depevster St., New York, N. v.— Richards Psyllium Seed, 344. Riedel-de Haen, Inc., 105 Hudson St., New York, N. Y. — Ampoules Solution Decholin-Sodium, 5 per cent, 10 cc; 2 per cent, 10 cc, 125; Decholin, 124; Decholin Sodium, 125; Decholin Tablets, SU grains, 124; Nostal, 108; Nostal Tablets, 0.1 Gm. (li^ grains), 108; Pernoston, 112; Pernoston Tablets, 3 grains, 112. Sandoz Chemical Works, Inc., 61-63 Van Dam St., New York, N. Y. — Ampules Calcium Gluconate-Sandoz, 151; Ampules Gynergen, 1 cc, 230; Ampules Gynergen Solution 1:2,000, 0.5 cc, 229; Ampules Scillaren-B, 187; Calcium Gluconate-Sandoz, 151; Gynergen, 229; Gynergen Solution.. 0.1 per cent, 230; Sandoptal, 116; Scillaren, 188; Scillaren-B, 187; Solution Scillaren, 188; Tablets Gynergen, 0.001 Gm., 230; Tablets Sandoptal, 0.2 Gm., 116; Tablets Scillaren, 188. Sargent's Drug Store, 23 N. Wabash Ave., Chicago, Illinois. — Petro- bran. 340. Schering & Glatz, Inc., 113 West 18th St., New York, N. Y. — Camio- fen Ointment, 248; Collargol, 427; Collargol Ointment, 427; Euphthalmine Hydrochloride, 99; Formalin, 237; locamfen, 248; 552 INDEX TO DISTRIBUTORS Schering & Glatz, Inc. (Continued) Medinal, 120; Medinal Suppositories, 10 grains, 120; Medinal Tablets, 5 grains, 120; Orpliol, 132; Urotropin, 237; Urotropin Tablets, 5 grains (0.3 Gm.) ; 7^ grains (0.5 Cm.), 237; Xeroform-S. and Ga., 135. Schering Corporatiox, Bloomfield, N. J. — Ampoule Solution Neo-Iopax, 20 cc, 266; Keo-Iopax, 265. ScHiEFFELiN & Co.. 16-26 Coopcr Square, New York, N. Y.— Schief- felin Psyllium Seed, 344. Scientific Sugar Co., Indianapolis, Ind. — Kinney's Cod Liver Oil Con- centrate Capsules, 3 minims, 465; Kinney's Cod Liver Oil Concen- trate Liquid, 464; Kinney's Cod Liver Oil Concentrate Liquid, Vials, 5 cc, 465. Scott & Bowxe, Bloomfield, X. J. — Scott's Norwegian Cod-Liver Oil (Flavored), 461; Scott's Norwegian Cod Liver Oil (Plain). 461. Searle, G. D. & Co., 4735-4743 Ravenswood Ave., Chicago, Illinois. — Aminophylline-Searle, 480; Ampoules Bismuth Sodium Tartrate- Searle, 1.5 per cent, 2 cc; 3 per cent, 2 cc; 1.5 per cent, 60 cc. vial; 3 per cent, 60 cc. vial, 132; Ampuls Gold Sodium Thiosulfate- Searle, 5 cc, 240; Ampules Mercurochrome-H. W. & D., 1%, 10 cc; 20 cc, 281; Ampules Sodium Morrhuate 5% with Benzvl Alcohol (Searle), 5 cc, 432; Ampules Sodium Thiosulphate (Searle), 5 cc; 10 cc, 433; Ampules Solution Aminophylline-Searle, 0.24 Gm., 10 cc; 0.48 Gm., 2 cc, 480; Arsphenamine-Searle, 81; Bismuth Sodium Tartrate-Searle, 132; Chiniofon-Searle, 164; Gold Sodium Thiosulfate-Searle, 240; Neoarsphenamine-Searle, 86; Procaine Bor- ate-Searle, 67; Solution Dextrose and Sodium Chloride Ampules, 20 cc. (Searle) with Benzvl Alcohol, 159; Sulfarsphenamine- Searle, 91; Sulfarsphenamine-Searle, 0.1 Gm.: 0.2 Gm.; 0.3 Gm.; 0.4 Gm.; 0.5 Gm. ; 0.6 Gm. Ampules, 91; Tablets Aminophylline- Searle, 0.1 Gm. (11/2 grains), 480; Tablets Aminophylline-Searle, 0.1 Gm. (iy2 grains), 480; Tablets Chiniofon-Searle, 0.25 (4 gr.), 164; Tablets Chiniofon-Searle Enteric Coated, 0.25 Gm. (4 grains), 164; Tablets Procaine Borate and Epinephrine, 67 Tablets Procaine Borate without Epinephrine, 67. Sevdel Chemical Company, 135 Halladay St., Jersey City, N. J. — Benzyl Alcohol-Seydel, 56. Sharp & Dohme, Philadelphia, Penna. — Acne Bacterin, 408; Acne Sero- bacterin-Mulford (Sensitized Acne Vaccine Polyvalent), 417; Aller- genic Extracts-Mulford, 32; Ampoule Solution Silver Nitrate, 1 Per Cent-Sharp & Dohme, 431; Ampules, Sodium Cacodylate-Mulford, 3/4 grain; 1^2 grains; 2 grains; 3 grains; 5 grains; 7 grains, 1 cc, 95; Ampules Sodium Cacodylate-Mulford, 15^ grains, 2 cc, 95; Ampuls Mercury Succinimide, % grain, 288; Antianthrax Serum- Mulford, 378; Antidysenteric Serum (Polyvalent), 379; Antipneu- mococcic Serum, Concentrated (Pneumococcus Antibody Globulin, Types I and II), 384; Antipneumococcic Serum, Types I and II Combined-Mulford, 383; Antimeningococcic Serum, 380; Antipneu- mococcic Serum Type I, 382; Antivenin (Bothropic), 371; Anti- venin (Xearctic Crotalidae), 372; Bacillen Emulsion "B. E.." 395; Botulinus Antitoxin (Human) Jensen-Salsbery, 371; Capsules Carbon Tetrachloride- S. & D.. 0.3 cc; 1 cc. 161; Cargentos, 426; Cargentos Capsules, 3 grains, 427; Cargentos Ointment, 5 Per Cent; 10 Per Cent, 427; Cargentos Urethral Suppositories, 427; Cholera Bacterin (Cholera Vaccine), 409; Cholera Serobacterin-Mulford, (Sensitized Cholera Vaccine). 417; Compressed Tablets, Protan, INDEX TO DISTRIBUTORS 553 Sharp & Dohme (Continued) 5 grains, 440; Cremo-Bismuth, 135; Dextrose U. S. P. (d-Glucose), 25 Gm., 50 cc. Ampoule Unbuffered, 159; Dextrose U. S. P. (d-Glu- cose), 25 Gm., 50 cc. Ampoule (Buffered), 159; Digitol, 193; Diph- theria Antitoxin, 485; Diphtheria Antitoxin (Bovine), 373; Diphtheria Toxin-Antitoxin Mixture, New Formula (Park-Banzhaf's 0.1 L-f), 390; Diphtheria Toxin for Schick Test Diluted Ready for Use- Mulford, 420; Diphtheria Toxoid, 400; Erysipelas Streptococcus Antitoxin (Concentrated) -Mulford, 374; Gelatin Compound Phenol- ized, 238; Hypodermic Tablets Mercuric Succinimide, 0.012 Gm. (ys grain), 288; Hypodermic Tablets Strophanthin, l/ooo grain (0.325 mg.) S & D.. 192; Insulin-Mulford. 327; Insulin-Mulford, 10 Units, 5 cc; 20 Units, 5 cc; 40 Units 5 cc; 10 Units, 10 cc. ; 20 Units, 10 cc; 40 Units, 10 cc; 80 Units, 10 cc. ; 100 Units, 10 CO., 327; lodo-Casein. 252; lod-Casein Tablets, 5 grains (0.3 Gm.) 252; Ivyol Poison Ivy Extract, 352; Ivyol Poison Ivy Extract (Syringes), 352; Ivyol-Poison Oak Extract-Mulford, 352; Ivyol- Poison Oak Extract (Syringes), 352; Normal Horse Serum, 366; Normal Horse Serum Without Preservative, 366; Perfringens Anti- toxin, 369; Pirquet Test for Tuberculosis, 394; Plague Bacterin, 410; Pneumococcus Antibody Globulin, Tvpe I-Mulford, 382; Pollens Dried-Miilford, 485; Pollen Extracts-Mulford, 43; PoUcn Extracts Diagnostic-Mulford, 485; Protan, 440; Proteins Dried-Mulford, 485; Rabies Vaccine (Phenol Killed)-Mulford, 388; Scarlet Fever Strep- tococcus Antitoxin Concentrated. 377; Scarlet Fever Streptococcus Toxin for the Dick Test-Mulford, 421; Scarlet Fever Streptococcus Toxin for Immunization-Mulford, 397; Staphylo-Serobacterin (Sen- sitized Staphylococcic Vaccine), 417; Tablets lodo-Casein with Chocolate, 252; Tetanus Antitoxin, 485; Tetanus Antitoxin (Bovine), 372; Tetanus Gas-Gangrene Antitoxin Mixed-Mulford, 369; Tincture Digitalis, Purified-S. & D., 186; Tincture Digitalis, Purified, S. & D., 485; Tuberculin "Old" (O. T.), 394; Tuberculin T. R., 395; Typho-Bacterin, 413; Typho-Bacterin Mixed (Triple Vaccine), 415; Typho-Serobacterin-Mulford Mixed (Sensitized Triple Vaccine), 418; Typho-Serobacterin-Mulford (Sensitized Typhoid Vaccine), 417; Vaccine Virus (Smallpox Vaccine), 485. Sheffield Farms Co., Inc.. 524-528 West 57th St., New York. — Shef- field B. Acidophilus Milk, 278. Sklar Manufacturing Co., J., 133-143 Floyd Street, Brooklyn, N. Y. — Mercurochrome Applicators, 291; Silver Nitrate Applicators (Arzol), 431. S. M. A. Corporation, Cleveland. Ohio. — Carotene-SMACO, 454; SMACO Carotene in Oil, 455; SMACO Carotene and Vitamin D Concentrate in Cod Liver Oil, 456; SMACO Carotene with Vitamin D Concentrate in Oil, 455; Smaco Vitamin D Concentrate in Oil, 465. Smith, Kline & French Laboratories, Philadelphia, Penna. — Benze- drine, 213; Benzedrine Inhaler, 214; Benzedrine Solution, 214; Pentnucleotide, 336; Pentnucleotide, vials, 10 cc, 337. Smith Oil & Refining Company, Rockford, 111. — Smith's Mineral Oil, 280. Squibb, E. R. & Sons, 745 Fifth Ave., New York, N. Y.— Acne Vac- cine, 408; Ampules lodobismitol with Saligenin, 2 cc, 142; Anti- meningococcic Servim, 381; Antipneumococcic Serum, Type I, 382; Arsphenamine-Squibb, 81; Autolyzed Liver Concentrate-Squibb, 313; Barium Sulfate-Squibb for Roentgen-Ray Work, 121; Chloramine-T (Squibb), 246; (Jinchophen-Squibb, 168; Concentrated Anti-Pneu- mococcic Serum, Types I and II, 384; Diphtheria Antitoxin-Sqiiibb, 485; Diphtheria Toxin for the Schick Test, Ready to Use without 554 INDEX TO DISTRIBUTORS Squibb, E. R. & Sons (Continued) Dilution- Squibb, 420; Diphtheria Toxoid-Squibb, 401; Diphtheria Toxin-Antitoxin Mixture (New Formula) (Sheep)-Squibb, 391; Ephedrine Hydrochloride-Squibb, 219; Erysipelas Streptococcus Antitoxin Concentrated-Squibb, 374; Insulin-Squibb, 327; Insulin- Squibb, 10 Units, 5 cc; 20 Units, 5 cc; 40 Units, 5 cc; 10 Units, 10 cc; 20 Units, 10 cc. ; 40 Units, 10 cc. ; 80 Units, 10 cc; 100 Units, 10 cc, 327; lodobismitol with Saligenin, 142; Ipral- Aminopyrine Tablets, 4.33 grains, 106; Ipral Calcium, 105; Ipral Calcium Tablets, ^^i grain; 2 grains, 105; Ipral Sodium, 106; Ipral Sodium Tablets, 4 grains, 106; Liquid Petrolatum Heavy California) Squibb, 280; Neoarsphenamine-Squibb, 86; Neocin- chophen-Squibb, 169; Normal Horse Serum, 366; Parathyroid Hor- mone-Squibb, 331; Parathyroid Hormone-Squibb, 5 cc. Vials, 331; Pituitary Solution-Squibb, 336; Pollen Allergen Solutions-Squibb. 36; Procaine Hydrochloride-Squibb. 70; Rabies Vaccine (Killed Virus) Squibb (Semple Method), 388; Refined Diphtheria Toxoid Alum Precipitated-Squibb, 405; Scarlet Fever Streptococcus Antitoxin Con- centrated, 377; Scarlet Fever Streptococcus Toxin for Dick Test- Squibb, 421; Scarlet Fever Streptococcus Toxin for Immunization- Squibb, 397; Smallpox (Variola) Vaccine (Glyceriymted), 485; Solargentum, 427; Soluble Gelatine Capsules Squibb Halibut Liver Oil with Viosterol, 3 minims, 471; Soluble Gelatine Capsules Squibb Plain Halibut Liver Oil, 3 minims, 469; Squibb Cod-Halibut Liver Oil, 469; Squibb Cod Liver Oil, 462; Squibb Cod Liver Oil with Viosterol, 463; Squibb Cod Liver Oil with Viosterol. Mint-Flavored, 463; Squibb's Mineral Oil with Agar, 280; Squibb's Mineral Oil with Agar and Phenol])hthalein, 280; Squibb Mint-Flavored Cod-Liver Oil, 462; Squibb Plain Halibut Liver Oil, 469; Squibb Stabilized Halibut Liver Oil with Viosterol, 470; Staphylococcus Vaccine. 411: Sterile Ampules Procaine Hvdrochloride-Squibb (Crystals) for Spinal Anesthesia. 50 mg.; 100 mg.; 120 mg. ; 150 mg.; 200 mg., 70; Sulfarsphenamine-Squibb, 91; Sulfarsphenamine-Squibh, 0.1 Gm.; 0.2 Gm.; 0.3 Gm.; 0.4 Gm.; 0.5 Gm.; 0.6 Gm.; 0.9 Gm.; 3.0 Gm. Ampules. 91; Tablets Digitalis-Squibb. 1 grain. 180; Tablets Digitalis Leaves-Squibb, 1 cat unit, 180; Tablets Ephedrine Hydrochloride- Squibb, ii grain; 34 grain, 219; Tablets Neocinchophen-Squibb. 5 grains, 169; Tablets Solargentum. 4.6 grains, 427; Tetanus Anti- toxin, Purified, 485; Thromboplastin Local-Squibb, 235; Thrombo- plastin Local-Squibb. 20 cc. Vial. 236; Thromboplastin Local-Squibb, Dental Package, six 4 cc. vials, 236; Thvroxin (Squibb). 443; Thyroxine Crude, 444; Thyroxine Tablets, 0.2 mg. ; 0.4 mg.; 0.8 mg. ; and 2.0 mg.. 444; Typhoid Vaccine Combined, Immunizing. 416; Typhoid Vaccine (Immunizing). 413; Viosterol in Oil-Squibb, 474. Stearns, Frederic & Co.. Detroit. Mich.^Insulin-Stearns, 328; Insulin- Stearns. 10 Units, 5 cc ; 20 Units. 5 cc; 40 Units, 5 cc; 10 LTnits. 10 cc; 20 Units, 10 cc. ; 40 Units, 10 cc; 80 Units, 10 cc; 100 Units, 10 cc, 328; Neo-Synephrin Hydrochloride, 224; Neo- Synephrin Hydrochloride Emulsion (Aromatic). 225; Neo-Synephrin Hydrochloride Jelly. 225; Solution Neo-Synephrin Hydrochloride, 0.25 Per Cent; 1 Per Cent, 225. Sterisol Ampoule Corp., The, 37-02 Northern Blvd., Long Island City, N. Y. — Sterisol Ampoule Dextrose, 5%, in Physiological Solu- tion of Sodium Chloride, 159; Sterisol Ampoule Physiological Solu- tion of Sodium Chloride, 342. Stevenson Mineral Oil Co., Coshocton, Ohio. — Stevenson's Heavy Rus- sian Mineral Oil (Mint Flavored), 485. Supplee-Wills-Jones Milk Co.. 1523 N. 26th St., Philadelphia, Penna.— Supplee B. Acidophilus Milk, 278. Tailby-Nason Company, Boston, Mass. — Nason's Palatable Cod Liver Oil, 460. INDEX TO DISTRIBUTORS 555 Takamine Laboratory, Inc., Clifton, N. J. — Hirathiol, 434. Terrell's Laboratories, Medical Arts Bldg., Fort Worth, Texas. — Rabies Vaccine (Phenolized), 389. UcoLiNE Products Co., 509 S. Franklin St., Chicago, 111. — Ucoline Cal- cium Phosphate Cocoa Wafers, 151; Ucoline Cod Liver Oil Concen- trate, 466; Ucoline Cod Liver Oil Concentrate Tablets, 467; Ucoline Standardized Cod Liver Oil, 462. Ulmer Laboratories, 416 S. Sixth St., Minneapolis, Minn. — Ampoules Biliposol Solution, 2 cc, 129; Biliposol, 129. Ulmer Pharmacal Co., 412 S. Sixth St., Minneapolis, Minn. — Sodium Morrhuate 5% Solution with Benzyl Alcohol (Ulmer), 5 cc; 20 cc. Vials, 432. Upsher Smith Company, 529 S. Seventh St., Minneapolis, Minn. — Pyrethrum Ointment, 347. U. S. Standard Products Co., Woodworth, Wis. — Ampoule Solution Quinine and Urea Hydrochloride, 0.5 Gm., 1 cc, 485; Ampule Com- pound Solution of Calcium Gluconate 10%, 10 cc, U. S. S. P. Co., 150; Ampuls Solution Caffeine Sodio-Benzoate, 2 cc, 153; Ampul Solution Sodium Cacodylate, 0.2 Gm. (3 grains); 0.34 Gm. (5 grains); 0.45 Gm. (7 grains), 5 cc, 95; Ampules Solution Sodium Cacodylate, 0.2 Gm, (3 grains); 0.32 Gm. (5 grains); 0.45 Gm. (7 grains), 1 cc, 95; Antimeningococcic Serum Polyvalent, 381; Bismuth Salicylate in Oil-U. S. S. P. Co., 134; Dextrose Solution, 25 Gm.. 50 cc; 50 Gm., 100 cc, 160; Diphtheria Antitoxin Refined and Con- centrated, 485; Diphtheria Toxin-Antitoxin Mixture, 0.1 L-f- Non- Sensitizing (Sheep), 391; Diphtheria Toxin for Schick Test and Control, 420; Diphtheria Toxoid-U. S. S. P. Co.. 401; Diphtheria Toxoid, Alum Precipitated, Refined, 405; Epinephrin Hydrochloride Solution 1:1,000 (U. S. S. P. Co.), 224; Epinephrin Powder- Wilson, 224; Erysipelas Streptococcus Antitoxin (Refined and Con- centrated), 375; Magnesium Sulfate 25% in 5 cc. Ampuls, 485; Normal Horse Serum, 366; Physiological Solution of Sodium Chloride, 50 cc. Bottle, 342; Physiological Solution of Sodium Chloride, 100 cc Bottle, 342; Pollen Extracts-U. S. S. P. Co., 46; Polyanaerobic Antitoxin (Tetanus-Gas-Gangrene) Refined and Con- centrated, 371; Rabies Vaccine (Killed Virus) Semple (U. _S. S. P. Co.), 389; Scarlet Fever Streptococcus Toxin for the Dick Test, 421; Scarlet Fever Streptococcus Toxin for Immunization, 397; Smallpox Vaccine (Vaccine Virus), 485; Tetanus Antitoxin, 485; Typhoid Paratyphoid Vaccine Combined, 416; Typhoid Vaccine, 413. V-A.LENTINE Company, Inc., Richmond, Va. — Solution Liver Extract- Valentine, 312. Wagner's Sons Co., The W. T., 1920-1926 Race St.. Cincinnati, Ohio.— Wagner's Artificial Vichy, 485; Wagner's Artificial Vichy Citrated, 485. Wall Chemicals, Inc., 1059-1065 W. Grand Blvd., Detroit, Mich.— Walco Ethylene for Anesthesia, 51. Wallace & Tiernan Products, Inc., Belleville, N. J. — Azochloramid, 243; Azochloramid Buffered Saline Mixture (vials containing azo- chloramid 0.3; 1.14; 0.6; 2.25 Gm.), 244; Azochloramid Solution in Triacetin, 1: 125, 244. 556 INDEX TO DISTRIBUTORS Werner Drug & Chemical Co., 914 Race St., Cincinnati, Ohio. — Phena- caine-Werner, 65. West Disinfecting Co., Long Island City, N. Y. — Phenoco, 174. White Laboratories, Inc., Newark, N. J. — White's Cod Liver Oil Con- centrate Capsules, 3 minims, 466; White's Cod Liver Oil Concentrate (Liquid), 465; White's Cod Liver Oil Concentrate, Liquid, Vials, 5 cc, 467; White's Cod Liver Oil Concentrate, Liquid, Vials, 50 cc, 466; White's Cod Liver Oil Concentrate, Tablets, 467. Wilder Co., Inc., The, P. O. Box 132, Richmond, Va. — Tablets Digitalis- Wilber, 1 14 grains, 180; Tincture Digitalis-Wilber, 186. Wilson Laboratories, 4221-4225 S. Western Ave., Chicago, Illinois. — Epinephrin Hydrochloride Solution-Wilson, 224; Epinephrin-Wilson, 224; Pituitary Solution U. S. P. (Wilson), 336. WiNTHROP Chemical Co., Inc., 170 Varick St., New York, N. Y. — Adalin, 147; Adalin Tablets, 5 grains (0.3 Gm.), 147; Agurin, 477; Alumnol, 48; Alypin, 53; Ampules Chaulmestrol, 1 cc; 3 cc, 163; Ampules Ephedrine-Novocain Solution, 1 cc; 2 cc, 69; Ampules Luminal-Sodium (Powder), 2 grains; 5 grains, 116; Ampules Luminal Sodium Solution in Ethylene Glycol, 2 cc, 116; Ampules Novocain Solution, 1 per cent, 2 cc, 68; Ampules Novo- cain Solution, 10 per cent, 2 cc. (For Spinal Anesthesia), 68; Ampules Novocain Solution, 1 per cent, with 1-Suprarenin Synthetic Bitartrate 1: 50,000; 1 cc, 2 cc, 3 cc, 6 cc, 68: Ampules Novocain Solution 2 per cent with 1-Suprarenin Synthetic Bitartrate 1:20,000, 1 cc, 3 cc, 6 cc, 69-69; Ampules Salyrgan Solution, 1 cc, 2 cc, 298-299; Ampules Solution Novocain, 2 per cent, 3 cc, 68; Ampules Sterile Crystals Novocain for Spinal Anesthesia, 50 mg. ; 100 mg. ; 120 mg. ; 150 mg. and 200 mg., 68; Ampules Sterile Solution Novocain, 20 per cent, 1.5 cc. ; 20 per cent, 5 cc, 68; Ampules Sterile Solution Novocain 20 per cent with 1-Suprarenin Synthetic Bitartrate 1:9,000, 1.5 cc; 5 cc, 68; Ampules Suprarenin Powder, 0.05 Gm., 223; Ampules Suprarenin Solution, 223; Ampules Triphal, 0.025 Gm.; 0.1 Gm., 240; Anaesthesine, IZ; Aristol, 249; Benzosol, 172; Capsules Luminal-Sodium, 5 grains, 116; Chaul- mesterol, 163; Creosotal-Winthrop, 171; Diodrast, 261; Diodrast Sterile Solution (35 per cent weight/volume), 10 cc; 20 cc. size, 262; Duotal, 172; Duotal Tablets, 5 grains, 172; Elixir of Luminal, 115; Elixir of Pyramidon, 346; Emulson Mesurol, 20 per cent, 136; Granules Protargol Compound, 426; Holo- caine, 65; Holocaine Solution, 1 per cent, 65; lothion, 252; lothion Oil, 252; Luminal, 115; Luminal Capsules, IJ^ grains, 116; Luminal Sodium, 115; Luminal-Sodium Tablets, ^; ^; IJ^ grains, 116; Melubrin, 345; Mesotan, 357; Mesurol, 136; Neosalvarsan, 87; Neosalvarsan, 0.15 Gm.; 0.3 Gm.; 0.45 Gm.; 0.6 Gm.; 0.75 Gm.; 0.9 Gm.; 1.5 Gm. ; 1.8 Gm. ; 3.0 Gm ; 4.5 Gm., 87; Novaspirin, 356; Novaspirin Tablets, 5 grains, 357; Novasurol, 294; Novasurol Ampules, 294; Novocain, 68; Novocain Hypodermic Tablets, 0.2 Gm., 69; Novocain Hypodermic Tablets. 0.05 Gm., 69; Novocain (0.125 Gm.) and 1-Suprarenin Synthetic Bitartrate (0.125 mg.), 69; Novocain Hypodermic Tablets, 0.02 Gm.. with 1-Suprarenin Syn- thetic Bitartrate, 0.02 mg., 69; Novocain (0.1 Gm.) and 1-Suprarenin Synthetic Bitartrate (0.25 mg.) Hypodermic Tablets, 69; Novocain 0.02 Gm.) and 1-Suprarenin Synthetic Bitartrate (0.05 mg.) Hypo- dermic Tablets, 69; Novocain (0.05 Gm.) and 1-Suprarenin Synthetic Bitartrate (0.083 mg.) Hypodermic Tablets, 69; Novocain (0.06 Gm.) and 1-Suprarenin Synthetic Bitartrate (0.06 mg.) Hypodermic Tablets, 69; Novocain (0.08 Gm.) and 1-Suprarenin Synthetic Bitar- trate (0.06 mg.) Hypodermic Tablets, 69; Novocain Solution, 1 Per Cent Ampules, 69; Orthoform, 74; Phanodorn, 113; Phanodorn Tablets, 3 grains, 114; Protargol, 426; Pyramidon, 346; Pyramidon INDEX TO DISTRIBUTORS 557 Winthrop Chemical Co. (Continued) Tablets, Ij/^ grains; 5 grains, 346; Sabromin, 147; Sabromin Tab- lets, 8 grains, 148; Sajodin, 260; Sajodin Tablets, 1; 8 grains, 260; Salophen, 341; Salvarsan, 82; Salvarsan, 0.1 Gm.; 0.2 Gm. ; 0.3 Gm.; 0.4 Gm.; 0.5 Gm.; 0.6 Gm.; 1 Gm.; 1.2 Gm. ; 2 Gm.; 3 Gm., Tubes, 82; Salyrgan, 298; Skiodan, 266; Silver-Salvarsan, 89; Silver- Salvarsan, 0.1 Gm.; 0.15 Gm.; 0.2 Gm.; 0.25 Gm. ; 0.3 Gm.; 0.6 Gm. Ampules, 89; Spirosal, 359; Sterile Ampules Novocain Crystals for Spinal Anesthesia, '3U0 mg. ; 500 mg., 69; Sterile Solution Skiodan (40 per cent by volume), 267; Sulfarsphenamine-Winthrop, 91; Sulfarsphenamine-Winthrop. 0.1 Gm.; 0.15 Gm.; 0.3 Gm. ; 0.45 Gm.; 0.6 Gm.; 0.75 Gm.; 0.9 Gm.; 3.0 Gm. Ampules, 91; Supra- renin, 223; Suprarenin Solution, 1:1,000, 223; Tablets Alypin, Ys grain, 54; Tablets Novocain, 1 grain, 69; Tablets Novocain, 0.01 Gm. with 1-Suprarenin Synthetic Bitartrate, 0.2 mg., 69; Tablets Skiodan, 1 Gm., 267; Tablets Suprarenin, 223; Tablets Theocin, ly^ grains, 480; Tablets Theocin Soluble, 2;.4 grains, 480; Tablets Tutocain, 0.03 Gm.; 0.1 Gm.; 0.05 Gm., 71; Tablets Tutocain, 0.03 Gm. with Suprarenin, 0.15 mg.; 0.06 mg., 71; Tablets Tutocain, 0.05 Gm. with Suprarenin. 0.125 mg., 71; Tannigen, 440; Theocin, 480; Theocin Soluble, 480; Triphal 240; Tutocain, 71; Veronal, 103; Veronal-Sodium, 120; Veronal-Sodium Tablets, 5 grains, 120; Veronal Tablets, 5 grains, 103; Winthrop Tablets of Salophen, 5 grains, 341; Winthrop Viosterol in Oil, 474. Wyeth & Brother, Inc., John, 1118 Washington Ave., Philadelphia, Penna. — Ampoule Solution Dextrose, 25 Gm. in 50 cc. ; 50 Gm. in 100 cc, 160; Wyeth's Capsules Digitalis Leaf, Defatted, 180. BIBLIOGRAPHICAL INDEX TO PROPRIE- TARY AND UNOFFICIAL ARTICLES NOT INCLUDED IN N.N.R. The references given below include : first, the date of original publication of the article in The Journal A. M. A., if it appeared there ; and, second, for the benefit of those that do not have access to files of The Journal, the place where the description may be found in other publications : "Reports of the Council on Pharmacy and Chemistry," "Propaganda for Reform," volumes 1 and 2, and "Reports of the A. M. A. Chemical Laboratory." Some reports have appeared in The Journal but not in the reports and vice versa. Council reports include reports on articles that have been considered by the Council, either at the request of the manufacturers or on the Council's own initiative. The names of the manufacturers (or their agents) follow the names of the preparations, except in those instances in which a drug is discussed in general, without reference to the product of any particular manufacturer. Abican (Rio Chemical Co.), The Journal, Feb. 13, 1915, p. 606; Reports Council Pharm. & Chem., 1914, p. 99; Propaganda, vol. 1, p. 43. Abscess Sero (California Endocrine Foundation Laboratories), The Jour- nal, July 5, 1924, p. 58. Acetonyl (Upjohn Co.), The Journal, May 20, 1933, p. 1597; Reports Council Pharm. & Chem., 1933, p. 29. Acet-Phenetidin Compound, P.-M. Co., Tablets (Pitman-Moore Co.), Reports Council Pharm. & Chem., 1918, p. 7Z. Acetylsalicylic Acid, L. & F. (Lehn & Fink), Reports Council Pharm. & Chem., 1923, p. 9. Acidophilus Bacillus Blocks-Mulford (Sharp & Dohme), The Journal, Dec. 22, 1934, p. 1947; Reports Council Pharm. & Chem., 1934, p. 7. Acidophilus Bacillus Liquid-Mulford (Sharp & Dohme), The Journal, Dec. 22, 1934, p. 1947; Reports Council Pharm. & Chem., 1934, p. 7. Acriviolet (National Aniline & Chemical Co., Inc.), The Journal, Feb. 6, 1932, p. 480; Reports Council Pharm. & Chem., 1931, p. 7. Acterol (Mead Johnson & Co.), The Journal, Oct. 5, 1929, p. 1067. Activin (Ernst Bischoff, Inc.), The Journal, May 11, 1929, p. 1783. Adalin-Luminal Tablets (Wintlirop Chemical Co.), Re,ports Council Pharm. & Chem., 1922, p. 7. Adex Tablets, Squibb (E. R. Squibb & Sons), The Journal, March 19, 1932, p. 983; Reports Council on Pharm. & Chem., 1932, p. 69; 1934, p. 122. Adrenal Comp. Vaginal Suppositories (H. K. Mulford & Co.), Reports Council Pharm. & Chem., 1923, p. 10. Adrenalinated Tricalcine (Laboratoire des "Produits Scientia") The Journal, March 14, 1925, p. 836; Reports Council Pharm. & Chem., 1925, p. 80. Adropsedema (Van Seaton Chemical Co.), The Journal, Oct. 10, 1925, p. 1152. Aerosan Tablets (Aerosan Co. of America), The Journal, Sept. 8, 1928, p. 727; Reports Council Pharm, & Chem., 1928, p. 7. Afsal (S. Lewis Summers), The Journal, Oct. 7, 1922, p. 1264. Agar Agar Wafers, Mansfield, Reports Council Pharm. & Chem., 1935, p. 15. Agar-Gran (Freeda Pharmacy) ; Reports Council Pharm. & Chem., 1933, p. 7. Agar-lac (E. Fougera & Co., Inc.), The Journal, Nov. 14, 1914, p. 1777; Reports Council Pharm. & Chem,, 1914, p. 124; Propaganda, vol. 1, p. 10. ii BIBLIOGRAPHICAL INDEX Agar-Mtdsion (Physicians & Hospitals Supply Co.), Reports Council Pharm. & Chem., 1928, p. 8. Agarol Compound (Wm. R. Warner & Co., Inc.), The Journal, May 30, 1925, p. 1682; Reports Chem. Lab., 1924-5, p. 20. Agmel (Maguey Products Co.), The Journal, Oct. 12, 1912, p. 1392. Ago-Cholan (E. Bilhuber), Thk Journal, Sept. 10, 1927, p. 901. Agrilin (Lehn & Fink, Inc.), The Journal, March 14, 1925, p. 837; May 30, 1925, p. 1682; Reports Chem. Lab., 1924-5, p. 20; Reports Council Pharm. & Chem., 1925, p. 7. Albargin (H. A. Metz Laboratories, Inc.), The Journal, Aug. 25, 1923, p. 677; Reports Council Pharm. & Chem, 1923, p. 10. Albasil (Ford Pharmacal Co.), Reports Council Pharm. & Chem., 1931, p. 8. Albolene, Reports Council Pharm. & Chem., 1935, p. 16. Albolene, Liquid (McKesson & Robbins), The Journal, July 26, 1913, p. 296; Reports Council Pharm. & Chem,, 1916, p. 65; Propaganda, vol. 2, p. 106. Alborum (The Whitehouse Chemical Co., Inc.), The Journal, Dec. 12, 1914, p. 2148; Reports Council Pharm. & Chem., 1914, p. 129. Albuminate of Iron, Solution of, and Elixir Paraldehyd (Robinson-Pettet Co., Inc.), Reports Council Pharm. & Chem., 1935, p. 18. Albutesta (Menley & James), The Journal, Nov. 1, 1930, p. 1347. Alcresta Dental Lotion-Lilly (Eli Lilly & Co.), The Journal, Oct. 29, 1921, p. 1441. Alcresta Ipecac (Eli Lilly & Co.), The Journal, Oct. 20, 1917, p. 1373; Reports Council Pharm. & Chem., 1917, p. 62; Propaganda, vol. 2, p. 153. Aletrin, The Journal, Nov. 13, 1909, p. 1655; Reports Council Pharm. & Chem., 1909, p. 135. Aletris Compound, Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 46. Aletris Compound, Elixir (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 46. Aletris Cordial (Rio Chemical Co.), The Journal, Oct. 17, 1914, p. 1411; Feb. 13, 1915, p. 606; Reports Council Pharm. & Chem., 1914. p. 99; Propaganda, vol. 1, p. 43. "Aleuronat" (Glogau & Co.), Reports Council Pharm. & Chem., 1931, p. 9. Alfatone (Norwich Pharmacal Company), The Journal, Aug. 7, 1915, p. 548; Reports Council Pharm. & Chem., 1915, p. 62; Propaganda, vol. 2, p. 28. Alimentary Elixir of Beef, Hart's (E. J. Harts & Co., Ltd.), The Journal, April 7, 1928, p. 1117; Reports Council Pharm. & Chem., 1928, p. 33. Alkalithia (Keasbey and Mattison Company), Reports Council Pharm. & Chem., 1919, p. 65; Propaganda, vol. 2, p. 242. Alkalol (Alkalol Co.), The Journal, Nov. 6, 1915, p. 1665; Reports Chem. Lab., 1915, p. 110. Alka Water (Carl H. Schultz Co.), The Journal, Oct. 31, 1931, p. 1301; Reports Council Pharm, & Chem., 1931, p. 10. Alleotone (B. F. Copeland), The Journal, Feb. 1, 1908, p. 379; Propa- ganda, vol. 1, p. 264. AUonal-Roche (Hoffmann-LaRoche Chemical Works), The Journal, March 29, 1924, p. 1066; June 12, 1926, p. 1853; May 25, 1929, p, 1783; Reports Council Pharm. & Chem., 1926, p. 7. Alpha-Dinitrophenol, The Journal, Feb, 17, 1934, pp, 542, 562. Alpha-Lobelin (Ernst Bischoff Co,, Inc.), The Journal, June 17, 1933, p. 1933; Reports Council Pharm. & Chem., 1933, p. 9. Alpha-Naphco (Carel Laboratories), The Journal, June 30, 1934, p. 2184; Reports Council Pharm. & Chem., 1934, p. 12. Alpha-Naphco Camphor Nasal Unguent (Carel Laboratories), The Jour- nal, June 30, 1934, p. 2184; Reports Council Pharm. & Chem., 1934, p, 12, Alpha-Naphco Cones (Carel Laboratories), The Journal, June 30, 1934, p, 2184; Reports Council Pharm, & Chem,, 1934, p, 12, Alpha-Naphco Menthol Suppositories (Carel Laboratories), The Journal, June 30, 1934, p. 2184; Reports Council Pharm, & Chem., 1934. p. 12. BIBLIOGRAPHICAL INDEX iii Alpha-Naphco Rectal Suppositories (Carel Laboratories), The Journal, June 30, 1934, p. 2184; Reports Council Pharm. & Chera., 1934, p. 12. Alpha-Naphco Zinc Stearate Camphor Ointment (Carel Laboratories), The Journal, June 30, 1934, p. 2184; Reports Council Pharm. & Chem., 1934, p. 12. Alpha-Naphco Zinc Stearate Powder (Carel Laboratories), The Journal, June 30, 1934, p. 2184; Reports Council Pharm. & Chem., 1934, p. 12. Alpha Naphthol Camphor Oil (Carel) (Carel Laboratories), Reports Council Pharm. & Chem., 1934, p. 16. Alphozone (Frederick Stearns & Co.), Reports Council Pharm. & Chem., 1916, p. SO; Propaganda, vol. 2, p. 99. Alqua Water (Shasta Water Co.), The Journal, Oct. 31, 1931, p. 1301; Reports Council Pharm. & Chem., 1931, p. 10. Alucol (The Wander Co.), The Journal, June 9, 1928, p. 1871; Reports Council Pharm. & Chem., 1928, p. 9. Amazine (Southwest Medical Supply Co.), The Journal, Dec. 20, 1930, p. 1933. Ambrine, The Journal, April 7, 1917, p. 1057; May 19, 1917, p. 1497; Reports Chem. Lab., 1917, p. 20; Propaganda, vol. 2, p. 330. American Ichthyol (Sulfo-Ichthyolate of Ammonium) (American Ich- thyol Syndicate), Reports Council Pharm. & Chem., 1930, p. 74. Amertan (Eli Lilly & Co.), Reports Council Pharm. & Chem., 1932, p. 7. Amidopyrine and Barbital, Combinations of, The Journal, Aug. 31, 1929, p. 713. Amidopyrine and the Barbituric Acid Derivatives, The Relation of, to Granulocytopenia, Reports Council Pharm. & Chem., 1935, p. 101. Aminoacetic Acid, Reports Council Pharm. & Chem., 1935, p. 18. Amiodoxyl Benzoate-Abbott (Abbott Laboratories), The Journal, March 19, 1932, p. 983; Reports Council Pharm. & Chem., 1932, p. 56. Ammonium Hypophosphite, Reports Council Pharm. & Chem., 1916, p. 51; Propaganda, vol. 2, p. 98. Ammonium Ichthyolate-Dayton (Dayton Chem. Co.), The Journal, March 31, 1928, p. 1039; Reports Council Pharm. & Chem., 1928 p. 10. Ammonium Ichthyolate-Meadows ("Ichty-Amon") (Meadows Chemical Co.), Reports Council Pharm. & Chem., 1928, p. 12. Ammonol (Ammonol Chemical Co.), The Journal, June 3, 1905, p. 1791; Feb. 2, 1918, p. 337; Reports Council Pharm. & Chem., 1905-8, p. 7; Propaganda, ed. 9, p. 9; Propaganda, vol. 2, p. 393. Amniotin (E. R. Squibb & Sons), The Journal, August 31, 1935, p. 667. Amniotin Capsules (E. R. Squibb & Sons), The Journal, August 31, 1935, p. 667. Amniotin in Oil (E. R, Squibb & Sons), The Journal, August 31, 1935, p. 667. Amniotin Pessaries (E. R. Squibb & Sons), The Journal, August 31, 1935, p. 667. Amolin Deodorant Powder (Amolin Chemical Co.), The Journal, Feb. 22, 1908, p. 626; Reports Chem. Lab., to 1909, p. 63. Ampoule Calcium Chloride 10% (Lakeside Lab's.), The Journal, March 21, 1936, p. 1008; Reports Council Pharm. & Chem., 1936, p. 9. Ampoule No. 61 Sodium Salicylate ISJ^ grains (Lakeside Laboratories, Inc.), The Journal, Jan. 4, 1930, p. 31; Reports Council Pharm. & Chem., 1929, p. 8. Ampoule No. 59 Sodium Iodide 15^ grains (Lakeside Laboratories, Inc.), The Journal, Jan. 4, 1930, p. 31; Reports Council Pharm. & Chem., 1930, p. 8. Ampoule No. 66X Sodium Salicylate, Sodium Iodide 155^ grains each (Lakeside Laboratories, Inc.), The Journal, Jan. 4, 1930, p. 31; Reports Council Pharm. & Chem., 1929, p. 8. Ampoule No. 66 Sodium Salicylate, Sodium Iodide and Colchicine (Lake- side Laboratories, Inc.), The Journal, Jan. 4, 1930, p. 31; Reports Council Pharm. & Chem., 1929, p. 8. Ampoule No. 50 Iron and Arsenic (Iron Cacodylate) 1 grain (Lakeside Laboratories, Inc.), The Journal, Jan. 4, 1930, p. 31; Reports Council Pharm. & Chem., 1929, p. 8. iv BIBLIOGRAPHICAL INDEX Ampoules Sodium Cacodylate for Intravenous Use-P. D. & Co. (Parke. Davis & Co.), The Journal, May 7, 1932, p. 1654; Reports Council Pharm. & Chem., 1932, p. 7. Ampule Preparations, Report on Sterility of, Reports Council Pharm. & Chem., 1935, p. 111. Ampules Sodium Cacodj'late 75^ grains (0.5 Gm.), 5 cc, (For Intra- venous Use); 15J^ grains (1.0 Gm.). For Intravenous Use (Cheplin Biological Lab's), The Journal, Dec. 23, 1933, p. 2050; Reports Council Pharm. & Chem., 1933, p. 13. Amyl Valerate, The Journal, Oct. 13, 1924, p. 1941; Reports Council Pharm. & Chem., 1924, p. 76. Amylzyme (G. W. Carnrick Co.), The Journal, Jan. 17, 1925, p. 220; Reports Chem. Lab., 1921, p. 72; Reports Council Pharm. & Chem., 1925, p. 19. Anadol (Wheeler Chemical Works), The Journal, May 21, 1919, p. 1704; Propaganda, vol. 1, p. 245. Analutos and Analutos Tablets (Royal Pharmaceutical Works, Meppel, Holland), The Journal, Feb. 20, 1915, p. 684; Reports Council Pharm. & Chem., 1915, p. 135; Reports Chem. Lab., 1915, p. 131. Anasarcin (Anasarcin Chemical Co.), The Journal, May 4, 1907, p. 1535; Dec. 8, 1917, p. 1992; Reports Council Pharm. & Chem., 1905-8, p. 54; Propaganda, vol. 1, p. 11; Propaganda, vol. 2, pp. 383, 407. Anayodin (Ernst Bischoff Co., Inc.), The Journal, Oct. 5, 1929, p. 1065; Reports Council Pharm. & Chem., 1929, p. 9. Anderson System for Treatment of Alcoholism (The Anderson Labora- tories), Reports Council Pharm. & Chem., 1916, p. 51. Androfort (Richter), The Journal, August 31, 1935, p. 667. Androl (Henning), The Journal, August 31, 1935, p. 667. Androstine-Ciba (Ciba Co.), The Journal, June 20, 1936, p. 2150; Reports Council Pharm. & Chem., 1936. p. 10. Anedemin (Anedemin Chemical Co.), The Journal, May 4, 1907, p. 1535; Dec. 8, 1917, p. 1992; Reports Council Pharm. & Chem., 1905-8, p. 54; Propaganda, vol. 1, p. 11; Propaganda, vol. 2, p. 383. Angler's Emulsion (Angler Chemical Co.), The Journal, Sept. 12, 1914, p. 962; Reports Council Pharm. & Chem., 1914, p. 48; Reports Chem. Lab., 1914, p. 55; Propaganda, vol. 1, p. 169. Animasa (Organotherapeutic Corporation), The Journal, July 10, 1926, p. 116; Reports Council Pharm. & Chem., 1926, p. 14. Anistamina (M. Olivetti), Reports Council Pharm. & Chem., 1915, p. 162. Anterior Lobe Sex Hormone Solution (Rovin) (A. M. Rovin Lab.), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Anterior Pituitary Desiccated-Lederle (Lederle Laboratories, Inc.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Anterior Pituitary Desiccated-P.-M. Co. (Pitman-Moore Co.), The Journal, June 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Anterior Pituitary Extract Squibb (E. R. Squibb & Sons), The Journal, August 31, 1935, p. 667. Antero-Pituitary Co, (Harrower Laboratory, Inc.), The Journal, Oct. 16, 1926, p. 1322. "Anti-Cept" (Anti-Cept Co.), The Journal, May 21, 1932, p. 1808; Reports Council Pharm. & Chem., 1932, p. 9. Antidiabeticum, Bauer (Sanin-Gesellschaft), The Journal, July 30, 1910, p. 418; Propaganda, vol. 1, p. 267. Antidysenteric Serum (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Antikamnia (Antikamnia Chemical Co.), The Journal, June 3, 1905, p. 1791; Feb. 8, 1908, p. 467; Reports Council Pharm. & Chem., 1905-8, p. 7; Reports Chem. Lab., to 1909, p. 60; Propaganda, vol. 1, pp. 9, 268, 307. Antikamnia and Quinin (Antikamnia Chemical Co.), The Journal, July 1, 1905, p. 55. Anti-Malta Fever Serum (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1917, p. 136. BIBLIOGRAPHICAL INDEX v Antimeristem-Schmidt (Laboratorium W. Schmidt), The Journal, March 8, 1913, p. 766; Dec. 6, 1919, p. 1787; Propaganda, vol. 2, p. 408. Antiopin (Dr. K. Yamada's Chemical Laboratory, Kobe, Japan, Walter Grautoff, New York, distributor), The Journal, June 11, 1932, p. 2062; Reports Council Pharm. & Chem., 1932, p. 9. Antiphlogistine (Denver Chemical Mfg. Co.), The Journal, June 1, 1907, p. 1875; Feb. 2Z, 1918, p. 557; Propaganda, vol. 2, p. 409. Anti-Pneumococcic Oil (Eimer and Amend), The Journal, Jan. 3, 1920, p. 46; Reports Council Pharm. & Chem., 1915, p. 52; Propaganda, vol. 2, p. 257. Antipneumococcic Serum Types I and II Containing Heterophile Anti- bodies-Lilly, The Journal, Aug. 15, 1936, p. 499; Reports Council Pharm. & Chem., 1936, p. 17. Antipneumococcic Serum, Types I, II and III, and Polyvalent, The Journal, April 5, 1924, p. 1138; Reports Council Pharm. & Chem., 1924, p. 7. Antipneumococcic Serum, Combined, Types I, II and III (The Gilliland Laboratories), The Journal, April 5, 1924, p. 1138; Reports Council Pharm. & Chem., 1924, p. 7. Antipneumococcic Serum, Polyvalent (H. K. Mulford Co.), The Jour- nal, April 5, 1924, p. 1138; Reports Council Pharm. & Chem., 1924, p. 7. Antipneumococcus Serum (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Antipneumococcus Serum, Polyvalent, Types I, II and III (The Lederle Antitoxin Laboratories), The Journal, April 5, 1924, p. 1138; Reports Council Pharm. & Chem., 1924, p. 7. Antiseptic Powder, Maignen (Maignen Institute), The Journal, Nov. 14, 1914, p. 1778; Reports Council Pharm. & Chem., 1914, p. 57; Propaganda, vol. 1, p. 19. Antiseptic Powder, Tyree's (J. S. Tyree), The Journal, Oct. 20, 1906, p. 1316; Aug. 24, 1912, p. 666; March 30, 1918, p. 949; May 17, 1919, p. 1482; Reports Council Pharm. & Chem., 1905-8, p. 22; Propaganda, vol. 1, pp. 21, 404; Propaganda, vol. 2, p. 462. Antiseptic Tablets, Clover (Sharp & Dohme), The Journal, Aug. 26, 1911, p. 755. Antistaphvlococcus Serum (Burroughs Wellcome & Co.), Reports Coun- cil Pharm. & Chem., 1917, p. 137. Antistreptococcus Serum, Aronson's (Schering & Glatz, Inc.), Reports Council Pharm. & Chem., 1917, p. 146. Antistreptococcic Serum (Cutter Laboratory), Reports Council Pharm. & Chem., 1925, p. 8. Antistreptococcic Serum (E. R. Squibb & Sons), The Journal, Feb. 15, 1930, p. 484; Reports Council Pharm. & Chem., 1930, p. 8. Antistreptococcic Serum (Eli Lilly & Co.), The Journal, Feb. IS, 1930. p. 484; Reports Council Pharm. & Chem., 1930, p. 8. Antistreptococcic Serum (Gilliland Laboratories, Inc.), The Journal Feb. 15, 1930, p. 484; Reports Council Pharm. & Chem., 1930, p. 8. Antistreptococcic Serum (National Drug Co.), The Journal, Feb. 15, 1930, p. 484; Reports Council Pharm. & Chem., 1930, p. 8. Antistreptococcic Serum (Parke, Davis & Co.), The Journal, Feb. 15, 1930, p. 484; Reports Council Pharm. & Chem., 1930, p. 8. Antistreptococcic Serum Polyvalent (H. K. Mulford Co.), The Journal, Feb. 15, 1930, p. 484; Reports Council Pharm. & Chem., 1930, p. 8. Antistreptococcic Serum Polyvalent (Lederle Laboratories, Inc.), The Journal, Feb. 15, 1930, p. 484; Reports Council Pharm. & Chem., 1930, p. 8. Antistreptococcic Serum Purified and Concentrated (Eli Lilly & Co.), The Juornal, Feb. 15, 1930, p. 484; Reports Council Pharm. & Chem., 1930, p. 8. Antistreptococcus Serum "Hoechst" (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Anti-Syphilitic Compound Sweeny (National Laboratories of Pittsburgh), The Journal, April 3, 1920, p. 965; Reports Council Pharm. & Chem., 1920, p. 12; Propaganda, vol. 2, pp. 268, 330. Antithermoline (G. W. Carnrick Co.), The Journal, Nov. 1, 1913, p. 1649. vi BIBLIOGRAPHICAL INDEX Antithyroid Preparations, Reports Council Pharm. & Chem., 1918, p. 50; Propaganda, vol. 2, p. 202. Antithyroidin-Moebius (Merck & Co.), Reports Council Pharm. & Chem., 1918, p. SO; Propaganda, vol. 2, p. 202. Antitoxoid in Tuberculosis (California Endocrine Foundation Labora- tories), The Journal, July 5, 1924, p. 58. Anti-Tuberculous Lymph Compound, Sweeny (National Laboratories of Pittsburgh), The Journal, April 3, 1920, p. 965; Reports Council Pharm. & Chem., 1920, p. 12; Propaganda, vol. 2, p. 266. Antityphoid Bile Vaccine (Besredka), The Joural, Oct. 21, 1922, p. 1446. Antiustio (Frederick Laboratory), The Journal, Nov. 16, 1929, p. 1559; Reports Council Pharm. & Chem., 1929, p. 11. Antophysin (Winthrop Chemical Co.), The Journal, Aug. 31, 1935, p. 667. Antuitrin-G (Parke, Davis & Co.), The Journal, Aug. 31, 1935, p. 667. Antuitrin-S (Parke, Davis & Co.), The Journal, Aug. 31, 1935, p. 667. Anusol Suppositories (Schering & Glatz, Inc.), The Journal, Oct. 2, 1909, p. 1112; Oct. 11, 1913, p. 1392; Jan. 31, 1914, p. 395; March 9, 1918, p. 719; Reports Chem. Lab. to 1909, p. 32; Propaganda, vol. 1, pp. 227, 280, 281; Propaganda, vol. 2, p. 182. Aloan (H. A. Metz Laboratories). The Journal, Nov. 8, 1924, p. 1526; Reports Council Pharm. & Chem., 1924 p. 8. Apergols (H. K. Wampole Co., Inc.), The Journal, Dec. 12, 1914, p. 2149; Reports Council Pharm. & Chem., 1914, p. 64; Propaganda, vol. 1, p. 26. Aphlegmatol (G. Giambalvo & Co.), The Journal, Aug. 21, 1920, p. 556; Reports Council Pharm. & Chem., 1920, p. 23; Propaganda. vol. 2, p. 273. Apiol, Reports Council Pharm. & Chem., 1923, p. 12. A. P. L. (Ayerst, McKenna & Harrison), The Journal, Aug. 31, 1935. p. 667. Apocactin (Wm. S. Merrell Co.), The Journal, July 2, 1927, p. 650. Aprotein (John Norton Co.), The Journal, Nov. 18, 1922, p. 1786; Reports Council Pharm. & Chem., 1922, p. 9. Aprotine (John Norton Co.), The Journal, Nov. 18, 1922, p. 1786; Reports Council Pharm. & Chem., 1922, p. 9. Aquazone (Oxvgen Water) (Aquazone Laboratories, Inc.), Reports Council Pharm. & Chem., 1920, p. 50; Propaganda, vol. 2, 290. Arbor Vitae, Reports Council Pharm. & Chem., 1912, p. 38. ARC Epilepsy Remedy (American Remedy Co.), The Journal, Oct. 1. 1927, p. 944. Argyrol (A. C. Barnes Co.), The Journal, March 17, 1928, p. 849; Reports Council Pharm. & Chem., 1928, p. 13. Arhovin (Schering & Glatz. Inc.), Reports of Council Pharm. & Chem., 1919, p. 66; Propaganda, vol. 2, p. 243. Aritine (Southwest Medical Supply Co.), The Journal, Dec. 20, 1930, p. 1933. Armervenol (Hille Laboratories), Reports Council Pharm. & Chem., 1919, p. 82; Propaganda, vol. 2, p. 249. Arrhenal (E. Fougera & Co.), The Journal, Feb. 26, 1921, p. 595; Propaganda, vol. 2, p. 492. Arro-Lin (Arro-Lin Chemical Industries, Inc.); Reports Council Pharm. & Chem., 1933, p. 20. Arsamine (S. Lewis Summers), The Journal, Sept. 1, 1928, p. 664. Arsenauro (Parmele Chemical Company), The Journal, Oct. 21, 1922, p. 1446. Arsenic and Mercury, Solution of (New York Intravenous Laboratory), The Journal, Aug. 2, 1919, p. 353; Reports Council Pharm. & Chem., 1919, p. 26; Propaganda, vol. 2, p. 231. Arseno-Meth. Hyd. See Arsenic and Mercury, Solution of Arsenoven, S. S. (S. S. Products Co.) The Journal, Aug. 2, 1919, p. 353; Reports Council Pharm. & Chem., 1919, p. 26; Propaganda, vol. 2, p. 231. Arsphenoids (Swan-Meyers Co.), The Journal, March 15, 1924, p. 888. BIBLIOGRAPHICAL INDEX vii Arteriosclerotic Serum (Herradora) for Intramuscular Use (Scientific Chemical Co.), The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Arthritine (Horovitz Biochemical Laboratories), The Journal, Dec. 21, 1929, p. 1974. Aseptikons (Chinosol Co.), The Journal, Nov. 14, 1914, p. 1778; Reports Council Pharm. & Chem., 1914, p. 124; Propaganda, vol. 1, p. 26. Aseptinol (Aseptinol Mfg Co.), The Journal, March 30, 1918, p. 949; Propaganda, vol. 2, p. 401. Aseptones (Scent-Ets Co.), The Journal, Jan. 14, 1928, p. 117; Reports Council Pharm. & Chem., 1927, p. 10. Asmoganglina (Neother Products Co.), The Journal, June 21, 1924, p. 2068; Reports Council Pharm. & Chem., 1924, p. 11. Aspatol (Standard Chemical Co., Des Moines, Iowa), The Journal, Feb. 14. 1925, p. 533; Reports Council Pharm. & Chem., 1924, p. 9; Reports Chem. Lab., 1924-5, p. 113. Aspirin (The Bayer Co., Inc.), The Journal, Jan. 20, 1917, p. 213; April 13, 1918, p. 1097; June 12, 1920, p. 1664; May 14, 1921, p. 1356; June 11, 1921, p. 1697; March 23, 1935, p. 1005; 1009; Reports Council Pharm. & Chem., 1916, p. 43; 1935, p. 29; Propa- ganda, vol. 2, pp. 116, 347, 480. Aspiro-Lithine (McKesson & Robbins), The Journal, May 2S, 1910. p. 1803; Propaganda, vol. 1, p. 281. Aspirophen (Cellarius Co.), The Journal, Jan. 21, 1911, p. 210; Reports Council Pharm. & Chem., 1911, p. 7; Propaganda, vol. 1, p. 85. Asthma Sero (California Endocrine Foundation Laboratories), The Jour- nal, July 5, 1924, p. 58. Asthmazine (Horovitz Biochemical Laboratories), The Journal, Dec. 21, 1929, p. 1974. Asthmol (Sagone & Co.), The Journal, July 11, 1931, p. 103; Reports Council Pharm. & Chem.. 1931, p. 12. Asthmol-phedrine (Sagone & Co.), The Journal, July 11, 1931, p. 103; Reports Council Pharm. & Chem., 1931, p. 12. Asthmolvsin (Agency Dr. Kade), The Journal, Oct. 17, 1925, p. 1234; March 12, 1927, p. 858; June 30, 1934, p. 2184; Reports Council Pharm. & Chem., 1934, p. 24. Atomidine (Schiefflin & Co.), The Journal, May 18, 1929, p. 1679; Reports Council Pharm. & Chem., 1929, p. 12. Atophan (Schering & Glatz. Inc.), The Journal, Aug. 9, 1919, p. 427. Sept. 6, 1919, p. 756; Reports Council Pharm. & Chem., 1921, p. 8; Propaganda, vol. 2, pp. 313. 373, 419. Atoquinol-Ciba, Reports Council Pharm. & Chem., 1935, p. 34, Atussin (Neother Products Co.), The Journal, June 21, 1924, p. 2068 Reports Council Pharm. & Chem., 1924, p. 11. Atychol (Oralee Company), The Journal, Aue. 24, 1929, p. 611 Reports Council Pharm. & Chem., 1929, p. 15. Auto-Hemic Serum (L. D. Rogers), The Journal, Feb. 14, 1920, p. 477 Propaganda, vol. 2, p. 409. Autolysin (Autolysin Laboratory), The Journal, July 24, 1915, p. 336 Nov. 6, 1915, pp. 1647, 1662; Propaganda, vol. 2, p. 413. Autolyzed Liver Preparations, Reports Council Pharm.. & Chem., 1935, p. 35. Avertin (E 107), The Journal, Sept. 8, 1928, p. 745. Avertin (Winthrop Chemical Co.), The Journal, Feb. 11, 1933, p. 443; June 24, 1933, p. 2038. Avesan (H) (Avesan Chemical Co.), The Journal. Jan. 3, 1931, p. 39. Azophene (Mallophene) (Mallinckrodt Chemical Works), The Journal, Dec. 30, 1933, p. 2121; Reports Council Pharm. & Chem., 1933, p. 21. Bacillus Acidophilus Culture (B. A. Culture), Reports Council Pharm. & Chem., p. 37. Bacillus Acidophilus Culture-Hollister-Stier, Reports Council Pharm. & Chem., p. 44. Bard-Parker Formaldehyde Germicide (Parker, White & Heyl, Inc.), The Journal, April 28, 1934, p. 1138; Reports Council Pharm. & Chem., 1934, p. 26. viii BIBLIOGRAPHICAL INDEX B. Iodine (B. Iodine Chemical Co.), The Journal, Feb. 1, 1919, p. 365; Reports Council Pharm. & Chem., 1918, p. 44; Reports Chem, Lab., 1918, p. 19; Propaganda, vol. 2, p. 198. B-Lac (Battle Creek Food Co.), Reports Council Pharm. & Chem., 1931, p. 23. B. Oleum Iodine (B. Iodine Chemical Co.), The Journal, Feb. 1, 1919, p. 365; Reports Council Pharm. & Chem., 1918, p. 44; Reports Chem. Lab., 1918, p. 19; Propaganda, vol. 2, p. 198. Baby Taeniafuge-Grape (Grape Capsule Co.), Reports Council Pharm. & Chem., 1915. p. 174. Bacillicide (Prophytol Products Co.), The Journal, Nov. 14, 1914, p. 1778; Reports Council Pharm. & Chem., 1914, p. 125. Bacilli Emulsion, Bovine (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Bacilli Emulsion, Koch's (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Bacillus Acidophilus Cultures, The Journal, Dec. 20, 1919, p. 1895; Reports Council Pharm. & Chem., 1919, p. 51. Bacillus Acidophilus Couture (Hollister-Stier), Reports Council Pharm. & Chem., 1935, p. 44. Bacillus Acidophilus Milk-Hermes (Hermes-Groves Dairy Co.), The Journal, May 14, 1932, p. 1744; Reports Council Pharm. & Chem., 1932, p. 11. Bacillus Bulgaricus-Squibb, The Journal, July 1, 1933, p. 34; Reports Council Pharm. & Chem., 1933, p. 21. Bacillus Vaccine, Friedlander. See Friedlander Bacillus Vaccine. Bakurol (Sharp & Dohme), The Journal, July 10, 1915, p. 175. Barbituric Acid Derivatives, The Relation of Amidopyrine and the, to Granulocytopenia, Reports Council Pharm. & Chem., 1935, p. 101. Baume Analgesique Bengue (Thos. Leeming & Co.), The Journal, Dec. 14, 1912, p. 2173; Propaganda, vol. 1, p. 267. Baneberry, Reports Council Pharm. & Chem., 1912, p. 38. Bannerman's Intravenous Solution (William Bannerman), The Journal, May 31, 1913, p. 1724; Jan. 2, 1915, p. 70; July 17, 1926, p. 191; Reports Council Pharm. & Chem., 1914, p. 131; Propaganda, vol. 1, p. 105. Baptisin, The Journal, Nov. 13, 1909, p. 1655; Reports Council Pharm. & Chem., 1909, p. 135. B. Coli-Combincd-Bacterin (The Abbott Laboratories), The Journal, June 22. 1918, p. 1967; Reports Council Pharm. & Chem., 1918, p. 11; Propaganda, vol. 2, p. 185. Bar-che-co (Barksdale Chemical Co.), The Journal, Dec. 18, 1926, p. 2114. Barbital Compound<; Intravenous Use of. The Journal, July 15, 1933, p. 208; Reports Council Pharm. & Chem., 1933, p. 107. Bayer-205, The Journal, May 23. 1925, p. 1591; May 13, 1933, p. 1558. B. B. Culture (B. B. Culture Laboratories), The Journal, July 1, 1933, p. 34; Reports Council Pharm. & Chem., 1933, p. 21. BCG Vaccine, The Journal, July 11, 1936, p. 132. Bee, Honey, Reports Council Pharm. & Chem.. 1912, p. 38. Bee Venom, The Journal, May 2, 1936, p. 1588. Beef, Extract, Concentrated Fluid (Armour & Co.), The Journal, Jan. 23, 1909, p. 311; Propaganda, vol. 1, p. 471. Beef Extract, Fluid (Cibilis Co.), The Journal, Jan. 23, 1909, p. 311; Propaganda, vol. 1, p. 472. Beef Extract. (Toin Special (G. H. Hammond & Co.), The Journal, Jan. 23, 1909, p. 311; Propaganda, vol. 1, p. 472. Beef, Extract of. Premier (Libby, McNeil & Libby), The Journal, Jan. 23, 1909, p. 311; Propaganda, vol. 1, p. 471. Beef Extract, Fluid, "Rex" (Cudahy Packing Co.), The Journal, Jan. 23, 1909, p. 311; Propaganda, vol. 1, p. 471. Beef Extract (Swift & Co.). The Journal, Jan. 23, 1909, p. 311; Propaganda, vol. 1, p. 471. Beef Juice, Wyeth's (John Wyeth & Bro.), The Journal, Nov. 20, 1909, p. 1754; Reports Council Pharm. & Chem., 1909, p. 137; Propaganda, vol. 1, p. 123. Befsal (Synthetic Organic Products Co.), The Journal, Feb. 21, 1925, p. 611; Report* Chem. Lab., 1924-5, p. 118. BIBLIOGRAPHICAL INDEX Ix Bell-ans (Bell & Co.), The Journal, Aug. 24, 1909, p. 569; May 9, 1914, p. 1492; Nov. 24, 1917, p. 1815; Feb. 23, 1918, p. 557; Reports Council Pharra. & Chem., 1909, p. 108; Propaganda, vol. 1, pp. 151, 282; Propaganda, vol. 2, pp. 380, 418. Benetol (Bcnetol Products Co.), Reports Council Pharm. & Chem., 1923, p. 13. Benzyl Alcohol-Van Dyk (Van Dyk & Co.), The Journal, April 17, 1926, p. 1233; Reports Council Pharm. & Chem., 1926, p. 21. Benzyl Benzoate for Therapeutic Use-Van Dyk & Co. (Synthetic Drug Corporation), The Journal, April 17, 1926, p. 1233; Reports Coun- cil Pharm. & Chem., 1926, p. 21. Benzyl Benzoate-Abbott, The Journal, March 4, 1933, p. 661; Reports Council Pharm. & Chem., 1933, p. 22. Benzyl Benzoate-Fritzsche, The Journal, March 4, 1933, p. 661; Reports Council Pharm. & Chem., 1933, p. 22. Benzyl-Benzoate-H. W. & D., The Journal, March 4, 1933, p. 661; Reports Council Pharm. & Chem., 1933, p. 22. Benzyl Benzoate-L. A. Van Dyk, 20 per cent, Aromatic (L. A. Van Dyk), The Journal, March 19, 1927, p. 944; Reports Council Pharm. & Chem., 1927, p. 11. Benzyl Benzoate-L. A. Van Dyk, 20 per cent (L. A. Van Dyk), The Journal, March 19, 1927, p. 944; Reports Council Pharm. & Chem., 1927, p. 11. Benzyl Benzoate-Mallinckrodt, The Journal, March 4, 1933, p. 661; Reports Council Pharra, & Chem., 1933, p. 22. Benzyl Benzoate-Merck, The Journal, March 4, 1933, p. 661; Reports Council Pharm. & Chem., 1933, p. 22. Benzyl Benzoate-Seydel (Seydel Chemical Co.), Reports Council Pharm. & Chem., 1931, p. 27. Benzyl Compounds, The Journal, March 4, 1933, p. 661; Reports Council Pharm. & Chem., 1933, p. 22. Benzyl Fumarate- Abbott, The Journal, March 4, 1933, p. 661; Reports Council Pharm. & Chem., 1933. p. 22. Benzyl Succinate-H. W. & D., Tablets of. The Journal, March 4, 1933, p. 661; Reports Council Pharm. & Chem., 1933, p. 22. Benzyl Succinate-Merck, The Journal, March 4, 1933, p. 661; Reports Council Pharm. & Chem., 1933, p. 22. Benzyl Succinate-Seydel (Seydel Chemical Co.), Reports Council Pharm. & Chem., 1931, p. 27. Benzylol (Van Dyk & Co.), The Journal, . April 17, 1926, p. 1233; Reports Council Pharm. & Chem., 1926, p. 21. Benzyl-Viburnum Compound (Benzyl- Viburnum Laboratories), The Jour- nal, Aug. 23, 1925, p. 628; Reports Council Pharm. & Chem., 1925, p. 9. Berberin Hydrochlorid, Reports Council Pharm. & Chem., 1922, p. 14. Betul-ol (E. Fougera & Co., Inc.), The Journal, Dec. 12, 1914, p. 2148; Reports Council Pharm. & Chem., 1914, p. 62; Reports Chem. Lab., 1914, p. 74; Propaganda, vol. 1, p. 27. Bichloridol (H. A. Metz Laboratories, Inc.), The Journal, Sept. 5, 1925, p. 764; Dec. 21, 1929, p. 1971; Feb. 22, 1930, p. 563; Reports Council Pharm. & Chem., 1925, p. 10. Bile Salts, Succinate of Soda and Phenolphthalein, Capsules of. Fair- child (Fairchild Bros. & Foster), Reports Council Pharm. & Chem., 1918, p. 59; Propaganda, vol. 2, p. 208. Biniodol (Charles C. Yarbrough), The Journal, Feb. 24, 1917, p. 650; Reports Council Pharm. & Chem., 1917, p. 10; Reports Chem. Lab., 1916, p. 108; Propaganda, vol. 2, p. 121. Biosol (Vito Chemical Laboratories), The Journal, March 8, 1913, p. 767; Propaganda, vol. 1, p. 284. Biosterin Ampules (Adsole Company of America), Reports Council Pharm. & Chem., 1927, p. 48. Bi-Oxo-Dyn ("Bi-Oxo-Dyn"), The Journal, Nov. 25, 1922, p. 1867; Reports Council Pharm. & Chem., 1922, p. 15. Bismogenol (E. Tosse & Co., Inc.), The Journal, March 19, 1927, p. 944; Reports Council Pharm. & Chem., 1927, p. 16. Bismoid (Eli Lilly & Co.), The Journal, May 26, 1934, p. 1761; Reports Council Pharm. & Chem., 1934, p. 28. Bismon (Kalle Color and Chemical Co.), Reports Council Pharm. & Chem., 1921, p. 12. X BIBLIOGRAPHICAL INDEX Bismuthal (Langley & Michaels Corp.), The Journal, April 17, 1926, p. 1233; Reports Council Pharm. & Chem., 1926, p. 22. Bismuth lodo-Resorcin Sulphonate, The Journal, Feb. 11, 1911, p. 441; Reports Chem. Lab., 1911, p. 14. Bismuth and Iron Citrate Soluble (Wellcome Brand) (Burroughs Well- come & Co.), Reports Council Pharm. & Chem., 1920, p. 51. Bismuth and Lithium Citrate Soluble (Wellcome Brand) (Burroughs Wellcome & Co.), Reports Council Pharm. & Chem., 1920, p. 51. Bismuthoidal (E. Fougera & Co.), The Journal, June 20, 1931, p. 2104; Reports Council Pharm. & Chem., 1931, p. 34. Bismuth, Opium and Phenol Tablets, The Journal, July 25, 1908, p. 330; Dec. 17, 1910, p. 2169; May 6, 1911, p. 1344; Reports Chem. Lab., to 1909, p. 28; 1910, p. 85; 1911, p. 22. Bismuth, Opium and Phenol Tablets (Hance Bros. & White), The Journal, July 25, 1908, p. 330; Dec. 17, 1910, p. 2169; May 6, 1911, p. 1344; Reports Chem. Lab., to 1909, p. 28; 1910, p. 85; 1911. p. 22. Bismuth, Opium and Phenol Tablets (Wm. S. Merrell Chemical Co.), The Journal, July 25, 1908, p. 330; Dec. 17, 1910, p. 2169; May 6, 1911, p. 1344; Reports Chem. Lab., to 1909, p. 28; 1910, p. 85; 1911, p. 22. Bismuth, Opium and Phenol Tablets (Sharp & Dohme), The Journal, July 25, 1908, p. 330; Dec. 17, 1910, p. 2169; May 6, 1911, p. 1344; Reports Chem. Lab., to 1909, p. 28; 1910, p. 85; 1911, p. 22. Bismuth, Opium and Phenol Tablets (F. Stearns & Co.), The Journal, July 25, 1908, p. 330; Dec. 17, 1910, p. 2169; May 6, 1911, p. 1344; Reports Chem. Lab., to 1909, p. 28; 1910, p. 85; 1911, p. 22. Bismuth, Opium and Phenol Tablets (Truax, Greene & Co.), The Jour- nal, July 25, 1908, p. 330; Dec. 17, 1910, p. 2169; May 6, 1911, p. 1344; Reports Chem. Lab., to 1909, p. 28; 1910, p. 85; 1911, p.22. Bismuth, Opium and Phenol Tablets (H. K. Wampole & Co., Inc.), The Journal, July 25, 1908, p. 330; Dec. 17, 1910, p. 2169; May 6, 1911, p. 1344; Reports Chem. Lab., to 1909, p. 28; 1910, p. 85; 1911, p. 22. Bismuth, Opium and Phenol Tablets (Wm. R. Warner & Co.), The Journal, July 25, 1908, p. 330; Dec. 17, 1910, p. 2169; May 6, 1911, p. 1344; Reports Chem. Lab., to 1909, p. 28; 1910, p. 85; 1911, p. 22. Bismuth Resorcinol Compound, Capsules (Gross Drug Co., Inc.), Reports Council Pharm. & Chem., 1917, p. 139; Propaganda, vol. 2, p. 157. BiSoDol (BiSoDol Co.), The Journal, March 10, 1928, p. 793; Oct. 29, 1932, p. 1511; Reports Council Pharm. & Chem., 1932, p. 12. Bi-Taride Tablets (Germicidal Products Corporation), The Journal, Sept. 16, 1916, p. 895; Reports Council Pharm. & Chem., 1916, p. 21. Bitter Bark, Reports Council Pharm. & Chem., 1912, p. 39. Bladder Wrack, Reports Council Pharm. & Chem., 1912, p. 39. Blandine Laxative, Mulford (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1914, p. 136. Blaud Capsules, Frosst's (C. E. Frosst & Co.), Reports Council Pharm. & Chem., 1915, p. 164; Propaganda, vol. 2, p. 56. Blaud, Arsenic and Strychnine Capsules, Frosst's (C. E. Frosst & Co.), Reports Council Pharm. & Chem., 1915, p. 164; Propaganda, vol. 2, p. 56. Blaud's Pills, The Journal, April 17, 1915, p. 1344; Reports Chem. Lab., 1915, p. 7. Blaudles (Wm. S. Merrell Co.), Reports Council Pharm. & Chem., 1922. p. 17. Blue Cohosh, The Journal, Sept. 11, 1915, p. 972; Reports Council Pharm. & Chem., 1912, p. 40. Blue Label Mineral Water (Carl F. Lauber, Inc.), Reports Council Pharm. & Chem, 1933, p. 24. Borcherdt's Malt, Cod Liver Oil and Iron Iodide (Borcherdt Malt Ext. Co.), Reports Council Pharm. & Chem., 1933, p. 25. Borcherdt's Malt Extract with Creosote (Borcherdt Malt Ext. Co.), Reports Council Pharm. & Chem., 1933, p. 25. Borcherdt's Malt Extract with Cascara Sagrada (Borcherdt Malt Ext. Co.), Report Council Pharm. & Chem., 1933, p. 25. Borocaine (Sharp & Dohme), The Journal, Oct. 26, 1929, p. 1309; Reports Council Pharm. & Chem., 1929, p. 16. BIBLIOGRAPHICAL INDEX xi Borolyptol (Palisade Mfg. Co.), The Journal, Nov. 15, 1913, p. 1812. Borosodine (A. Lumiere Laboratories), Reports Council Pharm. & Chem., 1924. p. IS. Borotetramine (Takamine Laboratories), The Journal, Feb. 19, 1921, p. 538; Reports Council Pharm. & Chem., 1921, p. 13. Bovinine (The Bovinine Co.), The Journal, Nov. 20, 1909, p. 1754; Reports Council Pharm. & Chem., 1909, p. 137; 1914, p. 105; Propa- ganda, vol. 1, p. 123; The Journal, March 14, 1931, p. 860; Reports Council Pharm. & Chem., 1931, p. 36. Brewers Yeast-Harris (The Harris Laboratories), The Journal, Nov. 3, 1934, p. 1378; Reports Council Pharm. & Chem., 1934, p. 129. Brobor. — See Episan. Bromhosal (Abbott Laboratories), The Journal, July 22, 1933, p. 280; Reports Council Pharm. & Chem., 1933, p. 100. Bromide and Acetanilide Compound-Mulford, Granular Effervescent (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1918, p. 58. Bromides with Cypripedium Compound (Truax, Greene & Co.), Reports Council Pharm. & Chem., 1912, p. 43. Bromides, Peacock's (Peacock Chemical Co.), The Journal, April 3, 1915, p. 1177; March 2, 1918, p. 643; Reports Council Pharm. & Chem., 1915, p. 24; Propaganda, vol. 1, p. 28; Propaganda, vol. 2, p. 400. Bromidia (Battle & Co.), The Journal, May 16, 1914, p. 1573, March 2, 1918, p. 642; Reports Council Pharm. & Chem., 1914, p. 15; Propaganda, vol. 1, p. 31; Propaganda, vol. 2, p. 399. Bromin-Iodin Compound (Bromin-Iodin Chemical Co.), The Journal, June 4, 1910, p. 1884; Dec. 2Z, 1916, p. 1956; Reports Council Pharm. & Chem., 1916, p. 40; Propaganda, vol. 1, p. 285; Propa- ganda, vol. 2, p. 97. Bromionyl (Upjohn Co.), The Journal, May 20, 1933, p. 1597; Reports Council Pharm. & Chem., 1933, p. 31. Bromionyl with Acetylsalicylic Acid (Upjohn Co.), The Journal, May 20, 1933, p. 1597; Reports Council Pharm. & Chem., 1933, p. 31. Bromionyl with Barbital (Upjohn Co.), The Journal, May 20, 1933, p. 1597; Reports Council Pharm. & Chem., 1933, p. 31. Brom-I-Phos (The National Drug Co.), The Journal, June 30, 1917, p. 2001; Reports Council Pharm. & Chem., 1917, p. 12; Reports Chem. Lab., 1917, p. 43; Propaganda, vol. 2, p. 136. Bromo-Mangan (Reinschild Chemical Co.), Reports Council Pharm. & Chem., 1915, p. 165. Broom Corn, Reports Council Pharm. & Chem., 1912, p. 39. Bruschettini Curative Vaccine; see Curative Vaccine Bruschettini. Buchu, Juniper and Acetate Potassium, Elixir (Pitman-Moore Co.), Reports Council Pharm. & Chem., 1915, p. 167. Buchu and Hyoscyamus Compound, Elixir of, Tyree's (J. S. Tyree), Reports Council Pharm. & Chem., 1915, p. 167; Propaganda, vol. 2, p. 57. Bulgara Tablets-H. W. & D. (Hynson, Westcott & Dunning), The Journal, June 4, 1927, p. 1831; Reports Council Pharm. & Chem., 1927, p. 20. Burnham's Iodine Ointment (Burnham Soluble Iodine Co.), The Journal, July 1, 1933, p. 33; Reports Council Pharm. & Chem., 1933, p. 26. Burnham's Soluble Iodine (Burnham Soluble Iodine Co.), The Journal, July 1, 1933, p. 33; Reports Council Pharm. & Chem., 1933, p. 26. Cactin, now Cactoid (The Abbott Laboratories), The Journal, Sept. 21, 1907, p. 1021; March 21, 1908, p. 956; April 4, 1908, p. 1140; March 12, 1910, p. 888; Aug. 6, 1910, p. 455; Reports Council Pharm. & Chem., 1910, p. 41; Propaganda, vol. 1, p. 37. Cactina (Sultan Drug Co.), The Journal, Sept. 21, 1907, p. 1021; March 21, 1908, p. 956; April 4, 1908, p. 1140; March 12, 1910, p. 888; Aug. 6, 1910, p. 455; Jan. 19, 1918, p. 185; July 9, 1927. p. 138; Reports Council Pharm. & Chem., 1910, p. 41; Propaganda, vol. 1, p. 37. Cactus Compound Pills (Heart Tonic), The Journal, April 29, 1916, p. 1387. xii BIBLIOGRAPHICAL INDEX Cactus Grandiflorus, The Journal, Sept. 21, 1907, p. 1021; March 12, 1910, p. 888; Jan. 7, 1911, p. 26; Reports Council Pharm. & Chem., 1910, p. 40; Propaganda, vol 1, p. 36. Calcidin Abbott (The Abbott Laboratories), The Journal, Sept. 7, 1907, p. 865; Reports Chem. Lab., to 1909, p. 7. Calcidin Tablets (The Abbott Laboratories), The Journal, Sept. 25, 1920, p. 892; Propaganda, vol. 2, p. 465. Calcium Cacodylate, Reports Council Pharm. & Chem., 1925, p. 12. Calcium Chloride, 10%, Ampoule (Lakeside Lab's), The Journal, March 21, p. 1008; Reports Council Pharm. & Chem., 1936, p. 9. Calcium Glycerophosphate, Reports Council Pharm. & Chem., 1916, p. 52. Calcium Peroxide-R. & H,, The Journal, April 22, 1933, p. 1237; Reports Council Pharm, & Chem., 1933, p. 29. Calcium Phenolsulfonate, Reports Council Pharm. & Chem., 1922, p. 24. Calcylates Compound, Elixir, The Journal, April 22, 1916, p. 1307. Calcylates Compounds, Pulvoids (The Drug Products Co.), The Jour- nal, June 14, 1919, p. 1784; Reports Council Pharm. & Chem., 1919, p. 19; Propaganda, vol. 2, p. 226. Callaway's Creosote, De-Monohydrated (Creo Chemical Distributing Co.), The Journal, May 28, 1932, p. 1884; Reports Council Pharm. & Chem., 1932, p. 14. Calmine (The Abbott Laboratories), The Journal, Jan. 14, 1911, p. 137; Propaganda, vol. 1, p. 286. Calomelol and Calomelol Ointment (Heyden Chem, Corp.), The Journal, Feb. 16, 1935, p. 922; Reports Council Pharm. & Chem,, 1935, p, 45. Calso Water (The Calso Co.), The Journal, Oct. 31, 1931, p. 1301; Reports Council Pharm. & Chem.. 1931, p. 10. Calumba-Agar (Reinschild Chemical Co.), The Journal, Nov. 11, 1933, p. 1561; Reports Council Pharm. & Chem., 1933, p, 7. Campetrodin and Campetrodin No, 2 (A, H. Robbins Company), The Journal, Sept, 21, 1918, p. 993; Reports Council Pharm. & Chem., 1918, p. 27; Reports Chem. Lab., 1918, p. 39; Propaganda, vol. 2, p. 193. Camphenol (Johnson & Johnson), The Journal, Nov, 5, 1910, p. 1662; Reports Chem. Lab., 1910, p, 112; Propaganda, vol, 1, p. 287. Campho-Phenique (Campho-Phenique Co.), The Journal, April 20, 1907, p. 1365; Feb. 9, 1918, p. 408; Reports Council Pharm. & Chem., 1905-8, p. 51; Propaganda, vol. 1, p. 40; Propaganda, vol. 2, p. 418. Campho-Phenique Powder (Campho-Phenique Co.), The Journal, April 20, 1907, p. 1365; Reports Council Pharm, & Chem,, 1905-8, p. 51; Propaganda, vol, 1, p. 40. Cancer Remedy, Koch's (Wm. F. Koch), The Journal, Feb. 12, 1921, p, 466; Feb. 19, 1921, p. 537; June 21, 1924, p. 2054; Propaganda, vol, 2, p. 437. Cancer Serum, Glover's (T, J. Glover), The Journal, Jan. 1, 1921, p. 52; Feb. 5, 1921, p, 396; June 21, 1924, p. 2054; Propaganda, vol. 2, p. 425. Cannabis Compound, Syrup (Pitman-Moore Co.), Reports Council Pharm. & Chem., 1915, p. 168. Capell's Uroluetic Test (Capell's Laboratory), The Journal, Aug. 23, 1919, p, 626. Caplets (Bio-Chemic Laboratories), The Journal, Feb. 25, 1922, p. 603. Caprokol (Sharp & Dohme), The Journal, May 25, 1935, p. 1909; Reports Council Pharm. & Chem., 1935, p, 76. Caps. Adreno-Spermin Comp. (Henry R, Harrower), The Journal, Jan, 18, 1919, p. 213; Reports Council Pharm, & Chem,, 1918, p. 42. Caps. Antero-Pituitary Comp. (Henry R. Harrower), The Journal, Jan, 18, 1919, p, 213; Reports Council Pharm. & Chem., 1918, p. 42. Caps. Hepato-Splenic Comp. (Henry R. Harrower), The Journal, Jan, 18, 1919, p. 213; Reports Council Pharm, & Chem,, 1918, p. 42. Caps. Pancreas Comp. (Henry R, Harrower), The Journal, Jan. 18, 1919, p. 213; Reports Council Pharm & Chem., 1918, p. 42. Caps, Placento-Mammary Comp, (Henry R, Harrower), The Journal, Jan, 18, 1919, p. 213; Reports Council Pharm, & Chem,, 1918, p. 42, Caps. Thyroid Comp. (Henry R. Harrower), The Journal, Jan. 18, 1919, p, 213; Reports Council Pharm. & Chem., 1918, p, 42, Caps, Tyro-Ovarian Comp, (Henry R, Harrower), The Journal, Jan. 18, 1919, p. 213; Reports Council Pharm. & Chem., 1918, p. 42, BIBLIOGRAPHICAL INDEX xiii Captol (Muhlens & KropflF), The Journal, Sept. 10, 1910, p. 959; Reports Chem. Lab., 1910, p. 70. Cargel (H. K. Mulford Co.), The Journal, Aug. 4, 1928, p. 321; Reports Council Pharm. & Chem., 1928, p. 21. Carminzyra (Fairchild Bros. & Foster), The Journal, Sept. 28, 1918, p. 1081; Reports Council Pharm. & Chem., 1918, p. 28; Propaganda, vol. 2, p. 194. Carnine (E. Fougera & Co., Inc.), The Journal, Nov. 20, 1909, p. 1754; Reports Council Pharm. & Chem., 1909, p. 137; Propaganda, vol. 1, p. 123. Caroid (American Ferment Co.), The Journal, Nov. 4, 1922, p. 1629; Dec. 16, 1922, p. 2104; Reports Council Pharm. & Chem., 1914, p. 109. Carpanutrine (John Wyeth & Bro.), The Journal, May 11, 1907, p. 1612; Reports Council Pharm. & Chem., 1905-8, opp. p. 64; Propa- ganda, vol. 1, p. 133. Carsinol (Carsinol Research Laboratories), The Journal, Jan. 17, 1925, p. 221; Reports Council Pharm. & Chem., 1924, p. 15; Reports Chem. Lab., 1924-5, p. 101. Carvitin (Carvitin Products Laboratories, Inc.), The Journal, Nov. 28, 1931, p. 1626; Reports Council Pharm. & Chem., 1931, p. 40. Casca-Aletris (Pullen-Richardson Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 46. Cascara-Agar (Reinschild Chemical Co.), The Journal, Oct. 26, 1929, p. 1309; Reports Council Pharm. & Chem., 1929, p. 17. Cascarans, Bell (Bell & Co.), The Journal, Aug. 14, 1909, p. 569; Reports Council Pharm. & Chem., 1909, p. Ill; Propaganda, vol. 1, p. 154. Castaflora (The Wm. S. Merrell Chemical Co.), The Journal, Jan. 27, 1917, p. 303; Reports Council Pharm. & Chem., 1916, p. 45; Propa- ganda, vol. 2, p. 118. Castrox (Purdue Newberry Co.), The Journal, Dec. 23, 1916, p. 1956; Reports Council Pharm. & Chem., 1916, p. 41. Catarrhal Immunogen (P. D. & Co.), The Journal, Sept. 22, 1934, p. 939. Catarrhal Vaccine No. 40 (G. H. Sherman), The Journal, Oct. 11, 1924, p. 1184; Reports Council Pharm. & Chem., 1924, p. 58. Catarrhal Vaccine Combined-Lilly (Eli Lilly & Co.), The Journal, June 22, 1918, p. 1967; Reports Council Pharm & Chem., 1918, p. 11; Propaganda, vol. 2, p. 187. Causticks (Tappan Zee Surgical Co.), The Journal, May 19, 1934, p. 1681; Reports Council Pharm. & Chem., 1934, p. 68. Causyth, The Journal, Aug. 11, 1928, p. 418. Causyth (Mallinckrodt Chemical Works, Ltd., of Canada), The Journal, March 1, 1930, p. 656. Caviblen (A. Grimme), Reports Council Pharm. & Chem., 1915, p. 176. Ceanothyn (Flint, Eaton & Co.), The Journal, March 20, 1926, p. 890; Feb. 8, 1930, p. 410; Reports Council Pharm. & Chem., 1926, p. 23; 1930, p. 16. Ccdron Seed, Reports Council Pharm. & Chem., 1912, p. 40. Celerina (Rio Chemical Co.), The Journal, Oct. 17, 1914, p. 1411; Feb. 13, 1915, p. 606; Reports Council Pharm. & Chem., 1912, p. 40; 1914, p. 99; Propaganda, vol. 1, p. 43. Celery, Reports Council Pharm. & Chem., 1912, p. 40. Celery and Guarana, Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 40. Celery and Guarana Compound, Elixir (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 40. Celery Compound, Elixir (Nelson, Baker & Co.), Reports Council Pharm. & Chem., 1912, p. 40. Celery Compound, Elixir (F. Stearns & Co.), Reports Council Pharm. & Chem., 1912, p. 40. Celery Compound, Elixir (Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912, p. 40. Celery, Elixir Guarana and (Hance Bros. & White), Reports Council Pharm. & Chem., 1912, p. 40. Cellasin (The Cellasin Co.), The Journal, July 5, 1924, p. 58. Cephaelin, Reports Council Phaim. & Cbem., 1918, p. 52; Propaganda, vol. 2, p. 203. xiv BIBLIOGRAPHICAL INDEX Cerelene (Holliday Laboratories), The Journal, Feb. 15, 1919, p. 513; Reports Council Pharm. & Chera., 1918, p. 48; Reports Chem. Lab., 1919, p. 30; Propaganda, vol. 2, pp. 219, 337, 362. Cerelose ("Dyno") (Corn Products Refining Co.), The Journal, July 13, 1935, p. 119. Chapoteaut's Wine; see Wine Chapoteaut's. Chiodrastis (H. K. Wampole & Co., Inc.), Reports Council Pharm. & Chem., 1912, p. 42. Chionacea (Nelson, Baker & Co.), Reports Council Pharm. & Chem., 1912, p. 42; The Journal, June 14, 1919, p. 1787. Chionanthus Compound, Elixir (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 42. Chionanthus (Special), Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 42. Chionia (Peacock Chemical Co.), The Journal, April 3, 1915, p. 1177; Reports Council Pharm. & Chem., 1912, p, 42; 1915, p. 24; Propa- ganda, vol. 1, p. 28. Chlorax (Chlorine Products Company, Inc.). Reports Council Pharm. & Chem., 1919, p. 70; Reports Chem. Lab., 1919, p. 57; Propaganda, vol. 2, p. 244. Chlorlyptus (Weeks Chemical Co.), The Journal, Nov. 27, 1920, p. 1512; Reports Chem. Lab., 1920, p. 75; Reports Council Pharm. & Chem., 1920, p. 28; Reports Chem. Lab., 1920, p. 75; Propaganda, vol. 2, p. 277. Chloron (Chlorine Products Company, Inc.), Reports Council Pharm. & Chem., 1919, p. 70; Reports Chem. Lab., 1919, p. 57; Propaganda, vol. 2, p. 245. Chologen (Leonard A. Seltzer), The Journal, Feb. 1, 1913, p. 383; Propaganda, vol. 1, p. 288. Chologestin (F. H. Strong Co.). The Journal, Dec. 11, 1915, p. 2108. Chondroitin (Wilson Lab's), The Journal, Jan. 25, 1936, p. 292; Reports (Council Pharm. & Chem., 1935, p. 46. Chromiac Tablets (Maltbie Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 44. Cinchophen B. P. C. (Benzol Products Co.), Reports Council Pharm. & Chem., 1933, p. 31. Cinchophen Water-Morganstern (Morganstern & Co.), Reports Council Pharm. & Chem., 1931, p. 37. Cineraria Maritima, The Journal, Nov. 11, 1911, p. 1630; Reports Council Pharm. & Chem., 1911, p. 48; Propaganda, vol. 1, p. 49. Cin-U-Form Lozenges (McKesson and Robbins), The Journal, Oct. 4, 1919, p. 1077; Reports Council Pharm. & Chem., 1919, p. 35; Propa- ganda, vol. 2, p. 237. Citarin (The Bayer Company, Inc.), The Journal, Feb. 20, 1915, p. 685; Reports Council Pharm. & Chem., 1914, p. 135. Citrin (Table Rock Laboratories), The Journal, April 5, 1930, p. 1067; Reports Council Pharm. & Chem., 1930, p. 19. Citrocarbonate (Upjohn Co.), The Journal, May 20, 1933, p. 1597; Reports Council Pharm. & Chem., 1933, p. 31. Citrocoll (Cellarius Co.), The Journal, Jan. 21, 1911, p. 210; Reports Council Pharm. & Chem., 1911, p. 7; Propaganda, vol. 1, p. 85. Citrophan (Gotham Corporation), The Journal, March 1, 1924, p. 734; Reports Chem. Lab., 1924-5, p. 52. Clauden (Eastbrook, Inc.), The Journal, April 7, 1928, p. 1116; Reports Council Pharm. & Chem., 1928, p. 22. Clavipurin (Gane & Ingram), The Journal, Oct. 14, 1933, p. 1228; Reports Council Pharm. & Chem., 1933, p. 38. Clover Compound, Syrup Red (Nelson, Baker & Co.), Reports Council Pharm. & Chem., 1912, p. 40. Coagulen-Ciba (Society of Chemical Industry, Basle, Switzerland), Reports Council Pharm. & Chem., 1920, p. 53; Propaganda, vol. 2, p. 290. Cod-Liver, Extract of, Wampole's Perfected Tasteless Preparation of (H. K. Wampole & Co., Inc.), The Journal, April 5, 1913, p. 1093; April 10, 1915, p. 1262; Reports Council Pharm. & Chem., 1915, p. 140; Propaganda, vol. 1, p. 52. Cod Liver Oil, Scott's Emulsion of (Now Scott's Emulsion), The Jour- nal, June 22, p. 2256; Reports Council Pharm. & Chem., 1935, p. 103. BIBLIOGRAPHICAL INDEX xv Cod Liver Oil and Phosphorus, The Journal, July 14, 1928, p. 97; Reports Council Pharm. & Chem., 1928, p. 23. Cod Liver Oil, Budwell's Emulsion of Nos. 1 and 2 (Budwell Phar- macal Co.), The Journal, Feb. 20, 1915, p. 684; Reports Council Pharm. & Chem., 1915, p. 135; Propaganda, vol. 2, p. 22. Cod Liver Oil Compound, Hagee's Cordial of the Extract of (Kathar- mon Chemical Co.), The Journal, Oct 13, 1906, p. 1208; April 10, 1915, p. 1262; Reports Council Pharm. & Chem., 1915, p. 138; Propaganda, ed. 9, pp. 51, 289; Propaganda, vol. 2. 429. Cod-Liver Oil Compound, Waterbury's Metabolized (Waterbury Chemi- cal Co.), The Journal, Oct. 9, 1909, p. 1201; Reports Council Pharm. & Chem., 1909, p. 115; Propaganda, vol. 1. p. 291. See also Compound, Waterbury's. Cod Liver Oil, Super D (Upjohn Co.), The Journal, May 20, 1933, p. 1597; Reports Council Pharm. & Chem., 1933, p. 31. Cod Liver Oil, Viking Palatable (See Viking Palatable Cod Liver Oil). Colalin (SchieflFelin & Co.), Reports Council Pharm. & Chem., 1918, p. 52; Propaganda, vol. 2, p. 203. Colchi-Methyl Capsules (H. K. Wampole & Co., Inc.), Reports Council Pharm. & Chem., 1915, p. 169. Colchi-Sal (E. Fougera & Co., Inc.), The Journal, March 20, 1915, p. 1016; Reports Council Pharm. & Chem., 1915, p. 136; Propa- ganda, vol. 1, p. 58. Collene (Collene Laboratories, Inc.), The Journal, Dec. 23, 1922, p. 2181; Reports Council Pharm. & Chem., 1922, p. 26. Collodaurum (Ideal Skin-Suture Material Co.), The Journal, Sept. 26, 1925, p. 997. "Colloidal Gold" (Kahlenberg-Klaus Co.). The Journal, Jan. 31, 1925, p. 387; Reports Council Pharm. & Chem., 1925, p. 13. Colloid Solution Material for Intravenous Transfusion, Hogan's (E. R. Squibb & Sons), Reports Council Pharm. & Chem., 1917, p. 147. Colloidine (Boracol Chemical Co.), The Journal, March 11, 1916, p. 831; Reports Council Pharm. & Chem., 1916, p. 7; Reports Chem- Lab., 1915, p. 127. Collosol Calcium (British Colloids, Ltd.), The Journal, Aug. 4, 1923, p. 409. Collosol Calcium (Crookes Laboratories, Inc.), The Journal, March 22, 1930, p. 920; Reports Council Pharm. & Chem., 1930, p. 20. Collosol Iodine (E. Fougera & Co., Inc.). The Journal, Sept. 8, 1917, p. 841; Reports Council Pharm. & Chem., 1917, p. 49; Propaganda, vol. 2, pp. 144, 223. Collosol Cocain (Anglo-French Drug Co., Ltd.), The Journal, April 12, 1919, p. 1094; Reports Council Pharm. & Chem., 1919, p. 8; Propaganda, vol. 2, pp. 221, 223. Collosol Kaolin (Crookes Laboratories), The Journal, May 3, 1930, p. 1406; Reports Council Pharm. & Chem., 1930, p. 23. Collosol Preparations (Collosol Argentum, Collosol Arsenicum, Collosol Cuprum, Collosol Ferrum, Collosol Hydrargyrum, Collosol lodin, Collosol Manganese, Collosol Quinn, and Collosol Sulfur) (Anglo- French Drug Co., Ltd.), The Journal, June 7, 1919, p. 1694; March 4, 1922. p. 674; Reports Council Pharm. & Chem., 1919, p. 14; Reports Chem. Lab., 1919, p. 109; Propaganda, vol. 2, p. 223. Collyrium, Wyeth (John Wyeth & Bro.), The Journal, May 17, 1913, p. 1557; Propaganda, Vol. 1, p. 292. Colobromidine (Colloidal Laboratories), The Journal, Jan. 10, 1925. p. 135; Reports Council Pharm. & Chem., 1924, p. 17. Colodine (Colloidal Laboratories), The Journal, Jan. 10, 1925, p. 135; Reports Council Pharm. & Chem., 1924, p. 17. Colon Bacillus Combined Vaccine (Modified Van Cott), No. 35 (G. H. Sherman), The Journal, Oct, 11, 1924, p. 1184; Reports Council Pharm. & Chem., 1924, p. 57. Colon Bacillus Vaccine, The Journal, Jan. 17, 1925, p. 220; Reports Council Pharm. & Chem., 1924, p. 20. C-O-M (H. E. Frees Company). The Journal, Aug. 11, 1923; p. 493; Reports Council Pharm. & Chem., 1923, p. 18. Compound Elixir of Phosphates and Calisaya. — See Tissue Phosphates, Wheeler's. xvi BIBLIOGRAPHICAL INDEX Compressible Capsules Mercury Salicylate-S. D. C. 1 grain, IJ^ srrains, 2 grains, for Intramuscular Injection (Synthetic Drug Co.), Reports Council Pharm. & Chem., 1933, p. 42. Concentrated Orchitic Solution (Orchitic Substance-Cousineau) (Cali- fornia Endocrine Foundation Laboratories). The Journal, Oct. 8, 1927, p. 1267; Reports Council Pharm. & Chem., 1927, p. 21. Condurango, Reports Council Pharm. & Chem., 1911, p. 54. Cooperation of the Pharmaceutical Houses, Reports Council Pharm. & Chem., 1920, p. 56. Copper Phenolsulphonate (The Abbott Laboratories), Reports Council Pharm. & Chem., 1916, p. 54. Corlutin (Reed & Carnrick), The Journal, Aug. 31, 1935, p. 667. Corn Plasters, Medicated, The Journal, June 18, 1932, p. 2209; Reports Council Pharm. & Chem., 1932, p. 58. Corpora Lutea Desiccated-P. D. & Co. (Parke, Davis & Co.), Thb Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Corpora Lutea Soluble Extract-P. D. & Co. (Parke, Davis & Co.), The Journal, Jan. 30, 1932, p. 402; Reports Council Pharm. & Chem., 1932, p. 55. Corpora Lutea Soluble Extract-Wilson (Wilson Laboratories), The Jour- nal, Jan. 30, 1932, p. 402; Reports Council Pharm. & Chem., 1932, p. 55. Corpus Luteum (G. W. Carnick Co.), Reports Council Pharm. & Chem., 1925, p. 19. Corpus Luteum, Desiccated-Armour (Armour & Co.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Corpus Luteum, Desiccated-Wilson (Wilson Laboratories), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Corpus Luteum Extract-Lederle (Lederle Laboratories, Inc.), The Jour- nal, Jan. 30, 1932, p. 402; Reports Council Pharm. & Chem., 1932, p. 55. Corpus Luteum-Lederle (Lederle Laboratories, Inc.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm, & Chem., 1930, p. 25. Corpus Luteum-P. M. Co. (Pitman-Moore Co.), The Journal. June 1, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Corpus Luteum Solution (Rovin) (A. M. Rovin Lab's, Inc.), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Coryfin (Winthrop Chemical Co.), Reports Council Pharm, & Chem., 1923, p. 19. Cotarnin Salts, The Journal, Nov. 22, 1919. p. 1625; Propaganda, vol. 2, p. 240; Reports Council Pharm. & Chem., 1919, p. 48. Coto. Reports Council Pharm. & Chem., 1913, p. 39. Cotoin, Reports Council Pharm. & Chem., 1913, p. 39. Cotton Process Ether. See Ether. Anesthesia, Cotton Process. Cream of Mustard (The Cream of Mustard Co., South Norwalk, Conn.). Reports Council Pharm, & Chem,, 1918, p, 79; Propaganda, vol. 2, p. 218. Cream of Sulphur, O'Grady's Medicated Mineral (John H. O'Grady, Minneapolis). Reports Council Pharm. & Chem., 1918, p. 81. Creo Ferrum (The Gross Drug Co., Inc.), Reports Council Pharm. & Chem., 1921, p. 16. Creofos (Delson Chemical Co.), The Journal, July 7, 1917, p. 58; Reports Council Pharm. & Chem., 1917, p. 34; Propaganda, vol. 2, p. 137. Creosote-Delson (Delson Chemical Co.), The Journal, July 7, 1917, p. 58; Reports Council Pharm. & Chem., 1917, p. 34; Propaganda, vol. 2, p. 137. Creosote, De-Monohydrated. Calloway's (Creo-Chemical Distributing Co.), The Journal, May 28, 1932, p. 1884; Reports Council Pharm. & Chem., 1932, p. 14. Creosotonic (Scott) (Dawson Pharmacal Co.), The Journal, Aug. 24, 1918, p. 680; Reports Council Pharm. & Chem., 1918, p. 25; Propa- ganda, vol. 2, p. 192. BIBLIOGRAPHICAL INDEX xvii Cresog (Cresog Laboratories Co.), The Journal, May 29, 1926, p. 1713; Reports Council Pharm. & Chem., 1926, p. 25. Crouitils, Simple No. 1 (Oaten Bread) (LaPorte & Gauthier), Reporti Council Pharm. & Chem., 1921, p. 17. Croustils, No. 2 (Dechloridised and Lactoscd) (LaPorte & Gauthier), Reports Council Pharm. & Chem., 1921, p. 17. Croustils, No. 3 (Glutinized) (LaPorte & Gauthier), Reports Council Pharm. & Chem., 1921, p. 17. Cu-Co-Ba Tarrant (The Tarrant Co.), The Journal, Sept. 25, 1920, p. 891. Culture-Lac (Special Pharmacal Products Co.), The Journal, Jan. 13, 1923, p. 127; Reports Council Pharm. & Chem., 1922, p. 27. Culture of Bacillus Bulgaricus-Fairchild (Fairchild Bros. & Foster), The Journal, June 4, 1927, p. 1831; Reports Council Pharm. & Chem., 1927, p. 20. Culture of the Bacillus Bulgaricus-Lederle (Lederle Antitoxin Labora- tories), The Journal, June 4, 1927, p. 1831; Reports Council Pharm. & Chem., 1927, p. 20. Cuprase (Anglo-French Drug Co., Ltd.), The Journal, April 12, 1919. p. 1095; July 5, 1924, p. 58; Reports Council Pharm. & Chem., 1919, p. 10; Reports Chem. Lab., 1919, p. 32; Propaganda, vol. 2, p. 222. Curare, The Journal, Jan. 15, 1910, p. 219; Reports Council Pharm. & Chem., 1910, p. 7. Curarin, The Journal, Jan. 15, 1910, p. 219; Reports Council Pharm. & Chem., 1910, p. 7. . Curative Vaccine, Bruschettini (A. Bruschettini), Reports Council Pharm. & Chem., 1915, p. 176; Propaganda, vol. 2, p. 58. Cyclopropane for Anesthesia (Ohio Chem. & Mfg. Co.), The Journal, Jan. 25, 1936, p. 292: Reports Council Pharm. & Chem., 1935, p. 48. Cypress Oil (Fritzsche Bros., Inc.), The Journal, April 7, 1934, p. 1154; Reports Council Pharm. & Chem., 1934, p. 34. Cypridol Capsules (E. Fougera & Co., Inc.), The Journal, Dec. 19, 1914, p. 2247; Reports Council Pharm. & Chem., 1914, p. 77; Propa- ganda, vol. 1, p. 59. Cystogen (Cystogen Chemical Co.), The Journal, Dec. 12, 1914, p. 2148; Reports Council Pharm. & Chem., 1914, p. 66; Propaganda, vol. 1, p. 60. Cystogen Aperient (Cystogen Chemical Co.), The Journal, Dec. 12, 1914, p. 2148; Reports Council Pharm. & Chem., 1914, p. 66; Propa- ganda, vol. 1, p. 60. Cystogen Lithia (Cystogen Chemical Co.), The Journal, Dec. 12, 1914, p. 2148; Reports Council Pharm. & (Them., 1914, p. 66; Propaganda, vol. 1, p. 60. Cysto-Sedative (Strong. Cobb & Co.), The Journal, Dec. 12, 1914, p. 2148; Reports Council Pharm. & Chem., 1914, p. 130; Propa- ganda, vol. 1, p. 61. Damiana, Allen's Compound Extract of (Allen-Pfeiffer Chemical Co.), The Journal, July 19, 1913, p. 211. Darpin (Rio Chemical Co.), The Journal, Feb. 13, 1915, p. 606; Reports Council Pharm. & Chem., 1914, p. 99; Propaganda, vol. 1, p. 43. Daytol (Dayton Chem. Co.), The Journal, March 31, 1928, p. 1039; Reports Council Pharm. & Chem., 1928, p. 10. D. C. P. 340 (Parke, Davis & Co.), The Journal, June 3, 1933, p. 1767; Reports Council Pharm. & Chem., 1933, p. 43. De-Germ (Century Pharmacal Products Co.), The Journal, May 21, 1932, p. 1808; Reports Council Pharm. & Chem., 1932, p. 41. Dental Solution, Lilly's (Lilly Dental Products Co.), The Journal, Feb. 21, 1931, p. 634. Den-To-Xon (The Zymethol Lab.), Reports Council Pharm. & Chem., 1933, p. 44. Desiccated Corpus Luteum-Armour (Armour & Co.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25, Desiccated Corpus Luteum-Wilson (Wilson & Co.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Desiccated Parathyroid Gland Preparations, Reports Council Pharm. & Chem., 1927, p. 24. Desiccated Parathyroid Gland- Armour (Armour & Co.), The Journal, Jan. 14, 1927, p. 117; Reports Council Pharm. & Chem., 1927, p. 23. xviii BIBLIOGRAPHICAL INDEX Desiccated Parathyroid Substance-Wilson (Wilson Laboratories), Reports Council Pharm. & Chem., 1927, p. 24. Desiccated Pituitary Body- Armour (Armour & Co.), The Journal, .July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Desiccated Pituitary Substance (Anterior Lobe) -Armour (Armour & Co.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Desiccated Pituitary Substance (Posterior Lobe) -Armour (Armour & Co.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Desitin (Desitin Chemical Co.), The Journal, Feb. 26, 1927, p. 666; Reports Council Pharm. & Chem., 1927, p. 24. Diabesan (Solosan Co.), The Journal, Nov. 28, 1925, p. 1747; July 29, 1933, p. 389; Reports Council Pharm. & Chem., 1925, p. 16. Diabetic Biscuit (Jireh Diabetic Food Co.), The Journal, March 22, 1913, p. 922. Diabetic Flour, Jireh (Jireh Diabetic Food Co.), The Journal, March 22, 1913, p. 922. Diabetic Food, Jireh (Jireh Diabetic Food Co.), The Journal, Dec. 14, 1912, p. 2174. Diamel (Maltbie Chemical Co.), The Journal, Jan. 22, 1927, p. 267. Diampysal, Reports Council Pharm. & Chem., 1935, p. 45. Dianol I, Dianol II, and Dianol III (Kalle & Co.), Reports Council Pharm, & Chem., 1913, p. 34; Reports Chem. Lab., 1913, p. 75. Diastos, Liquor (H. K. Mulford Co.), The Journal, Feb. 9, 1907, p. 533. Diatussin (E. Bischoff & Co.), The Journal, May 17, 1913; p. 1557; Propaganda, vol. 1, p. 293. Diazyrae Essence (Fairchild Bros. & Foster), Reports Council Pharm. & Chem., 1927, p. 27. Diazyme Glycerol (Fairchild Bros. & Foster), The Journal, June 14, 1930, p. 1919; Reports Council Pharm. & Chem., 1930, p. 28. Di-Citurin (Chemico-Biologic Laboratories), Reports Council on Pharm. & Chem., 1930, p. 27; The Journal, March 21, 1931; Reports Council Pharm. & Chem., 1931, p. 41. Di-Crotalin (Swan-Myers Co.), The Journal, Aug. 17, 1918, p. 592; Propaganda, vol. 2, p. 465. Digestive Tablets, Aromatic (Fraser Tablet Co.), The Journal, Aug. 20, 1910, p. 710; Reports Chem. Lab., 1910, p. 67; Propaganda, vol. 1, p. 232. Digestive Tablets, Aromatic (Wm. S. Merrell Chemical Co.), The Journal, Aug. 20, 1910, p. 710; Reports Chem. Lab., 1910, p. 66; Propaganda, vol. 1, p. 231. Digestive Tablets, Aromatic (H. K. Mulford Co.), The Journal, Aug. 20, 1910, p. 710; Reports Chem. Lab., 1910, p. 65; Propaganda, vol. 1, p. 230. Digestive Tablets, Aromatic (Parke, Davis & Co.), The Journal, Aug. 20, 1910, p. 710; Reports Chem. Lab., 1910, p. 66; Propaganda, vol. 1, p. 231. Digestive Tablets, Aromatic (Sharp & Dohme), The Journal, Aug. 20, 1910, p. 710; Reports Chem. Lab., 1910, p. 66; Propaganda, vol. 1, p. 231. Digestive Tonic (Truax, Greene & Co.), Reports Council Pharm. & Chem., 1912, p. 44. Digifortis (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1925, p. 75. Digisine, Reports Council Pharm. & Chem., 1935, p. 134. Digitalin, True, Reports Council Pharm. & Chem., 1935, p. 52, Digitalis Tablets, Westerfield's (Westerfield Pharmacal Co.), Reports Council Pharm. & Chem., 1918, p. 75; Propaganda, vol. 2, p. 215. Digitalone (Parke, Davis & Co.), The Journal, June 12, 1909, p. 1938; Dec. 7, 1912, p. 2074; Jan. 11, 1913, p. 143. Digitalysatum (E. Bischoflf & Co.), The Journal, Feb. 15, 1913, p. 499; Jan. 8, 1916, p. 135; Reports Council Pharm. & Chem., 1915, p. 93: Propaganda, vol. 2, p. 63. Digitex (Drug Products Co.), Reports Council Pharm. & Chem., 1928, p. 27. Di-Hydranol (Sharp & Dohme), The Journal, May 12, 1934, p. 1564; Reports Council Pharm. & Chem., 1934, p. 37. BIBLIOGRAPHICAL INDEX xix Dimenformon (Organon Laboratories), The Journal, August 31, 1935, p. 667. Dimol (Anglo-French Drug Co.), The Journal, Oct. 6, 1923, p. 1224. Dinitrophenol, The Journal, April 7, 1934, p. 1156; Jan. 19, 1935, p. 237; June 29, 1935, p. 2385; July 6, 1935, p. 31; July 13, 1935. p. 124. Dionol (Dionol Company), The Journal, Jan. 26, 1918, p. 257; Feb. 7, 1920, p. 410; Propaganda, vol. 2, p. 422. Dioradin (Dioradin Co.), The Journal, Oct. 26, 1912, p. 1556; Reports Council Pharm. & Chem., 1912, p. 23; 1913, p. i7\ Propaganda vol. 1, p. 7i. Dioscorea Compound, Elixir (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912, p. 46. Dioscorea Compound, Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 46. Dioscorea (Compound, Elixir (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 46. Dioscorea Compound, Elixir (F. Stearns & Co.), Reports Council Pharm. & Chem., 1912, p. 46. Dioviburnia (Dios Chemical Co.), The Journal, Aug. 31, 1912, p. 735; Jan. 9, 1915, p. 166; Reports Council Pharm. & Chem., 1912, p. 46; 1914, p. 86; Propaganda, vol. 1, pp. 139, 410. Diphtheria Antitoxin (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Diphtheria Antitoxin, Concentrated (National Vaccine and Antitoxin Institute), Reports Council Pharm. & Chem., 1921, p. 23. Diphtheria Antitoxin Serum (Burroughs, Wellcome & Co.), Reports Council Pharm. & Chem., 1922, p. 30. Diphtheria Bacillus Vaccine, Reports Council Pharm. & Chem., 1918, p. 54. Disodium Salt of Tetraiodo-Ortho-Sulphobenzoic Acid, (H. W. & D.). Reports Council Pharm. & Chem., 1935, p. 60. Disulphamin (American Bio-Cheraical Laboratories), The Journal, Nov. 29, 1930, p. 29. Diuretin (Knoll & Co.), The Journal, April 4, 1914, p. 1108; Reports Chem. Lab., 1914, p. 7; Propaganda, vol. 1, p. 251. Diurol (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912. p. 45. Dixon's Suspension of Dead Tubercle Bacilli, Reports Council Pharm. & Chem., 1917, p. 140; Propaganda, vol. 2, p. 158. Dixon's Tubercle Bacilli Extract, Reports Council Pharm. & Chem., 1917, p. 140; Propaganda, vol. 2, p. 158. Dogwood, Flowering, Reports Council Pharm. & Chem., 1912, p. 41 Duodenin, Armour (Armour & Co.), The Journal, Aug. 14, 1915, p. 639; Jan. 15, 1916, pp. 178, 208; Reports Council Pharm. & Chem., 1915, pp. 96, 99, 151; 1916, p. 72; Propaganda, vol. 2, p. 76. Duotonol Tablets (Schering & Glatz, Inc.), The Journal, Sept. 30, 1916, p. 1033; Reports Council Pharm. & Chem., 1916, p. 34; Propa- ganda, vol. 2, p. 94. "Dyno," Reports Council Pharm. & Chem., 1935, p. 60. Dysentery Bacterin-Mulford (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1917, p. 141. Dyspepsia Compound, Elixir (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912, p. 44. Dyspepsia, Elixir Atonic, Phenolated (Wm. S. Merrell Chemical Co.) The Journal, Feb. 9, 1907, p. 533. Echinacea, The Journal, Nov. 27, 1909, p. 1836; Reports Council Pharm. & Chem., 1909, p. 144; Propaganda, vol. 1, p. 79. Echitone (Strong, Cobb & Co.), The Journal, Jan. 2, 1915, p. 71; July 17, 1920, p. 193; Reports Council Pharm. & Chem., 1914, p. 80; Propaganda, vol. 1, p. 81. Echthol (Battle & Co.), The Journal, March 13, 1909, p. 904; Jan. 2, 1915, p. 71; Reports Council Pharm. & Chem., 1909, p. 144; 1912. p. 38; 1914, p. 80; Propaganda, vol. 1, p. 81. Echtisia (Wm. S. Merrell Chemical Co.), The Journal, Jan. 2, 1915, p. 71; Reports Council Pharm. & Chem., 1914, p. 80; Propaganda, vol. 1, p. 81. XX BIBLIOGRAPHICAL INDEX Eclo Tablets (Pitman Moore Co.), The Journal, Aug. 18, 1928, p. 515. Edema Tablets (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 41. Edema Tablet (Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912, p. 41. Edema Improved, Tablet (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 41. Edwenil (Spicer & Company), The Journal, Oct. 7, 1933, p. 1154; Reports Council Pharm. & Chem., 1933, p. 62; The Journal, Jan. 11, 1936, p. 126. EfeDron Nasal Jelly (Hart Drug Co.), The Journal, Feb. 8, 1930, p. 430. Efedron (Hart), (Hart Drug Corp.), The Journal, May 19, 1934, p. 1701. Efemist (Hart), (Hart Drug Corp.), The Journal, May, 19, 1934, p. 1701. Eka Salt (Sharp & Dohme), The Journal, June 7, 1930, p. 1859; Reports Council Pharm. & Chem., 1934, p. 46. Elarson (Winthrop Chemical Company, Inc.), Reports Council Pharm, & Chem., 1919, p. 75; Propaganda, vol. 2, p. 248. Elder, Reports Council Pharm. & Chem., 1912, p. 41. Elder Flower Eye Lotion (George B. Evans Laboratories, Inc.), Reports Council Pharm. & Chem., 1930, p. 29. Electrargol (E. Fougera & Co.), Reports Council Pharm. & Chem., 1920, p. 58. Electr-Hg (E. Fougera & Co., Inc.), Reports Council Pharm. & Chem., 1924, p. 21. Elixir Arsylen Compositum-Roche ("Tonikum"-Roche) (Hoffmann La Roche, Inc.), The Journal, Jan. 9, 1932, p. 143; Reports Council Pharm. & Chem., 1932, p. 90. Elixir Aurine, Reports Council Pharm, & Chem., 1935, p. 62. Elixir Digitalin Compound (American Laboratories, Inc.), The Journal, May 1, 1926, p. 1383; Reports Council Pharm. & Chem., 1926, p. 55. Elixir of Bitter Wine, Triner's American (Jos. Triner), The Journal, July 14, 1917, p. 139; Reports Council Pharm. & Chem., p. 36; Propaganda, vol. 2, p. 139. Elixir of Enzymes (Armour & Co.), The Journal, June 14, 1930, p. 1919; Reports Council Pharm. & Chem., 1930, p. 28. Elixir Glycerophosphates, Nux Vomica and Damiana (Sharp & Dohme), The Journal, Sept. 30, 1916, p. 1034; Reports Council Pharm. & Chem., 1916, p. 35; Propaganda, vol. 2, p. 95. Elixir Kacyan McNeil, The Journal, June 1, 1929, p. 1838; Reports Council Pharm. & Chem., 1929, p. 58. Elixir Novo-Hexamine (Upsher Smith), Reports Council Pharm. & Chem., 1917, p. 142; Reports Chem. Lab., 1917, p. 70. Emmenin (Ayerst, McKenna & Harrison), The Journal, August 31, 1935, p. 667. Empyroform (Scherling & Glatz, Inc.), Reports Council Pharm. & Chem., 1918, p. 55. Emulsio Minerolein (T. R. D. Barse Co.), Reports Council Pharm. & Chem., 1915, p. 169. Emulsio Phen-Oleum (T. R. D. Barse Co.), Reports Council Pharm. & Chem., 1915, p. 169. Endotin (Morganstern & Co.), Reports Council Pharm. & Chem., 1914, p. 136. Endo-Ovarina Tablets (Neother Products Co.), The Journal, June 21, 1924, p. 2068; Reports Council Pharm. & Chem., 1924, p. 11. Enemose (Fairchild Bros, & Foster), Reports Council Pharm, & Chem., 1922, p. 48. Energen Food Products (Energen Bismeal, Energen Cocoa, Energen Digestive Biscuits, Energen Endobran Biscuits, Energen Gluten Semolina, Energen Gluten Tapioca, Energen Macaroni, Energen Pastry Flour, Energen Protein Food, Energen Starch-Reduced Bread [Batons], Energen Starch-Reduced Bread with Casein [Batons], Energen Starch-Reduced Rolls, Energen Starch-Reduced Wheatmeal Bread [Batons], Energen Starch-Reduced Rusks) (Energen Foods Co., Inc.), The Journal, Aug. 3, 1929, p. 381; Reports Council Pharm. & Chem., 1929, p. 59. BIBLIOGRAPHICAL INDEX xxi Enesol (E. Fougera & Co., Inc.), The Journal, July 26, 1913, p. 293. "Ensol," The Journal, October 5, 1935, p. 1122. Ensol (Dr. H. C. Connel), The Journal, May 9, 1936, p. 1654. Enterocap Oralsulin (Lafayette Pharmacal Co.), The Journal, Dec. 4, 1926, p. 1935. Enteronol (Enteronol Co.), The Journal, March 21, 1908, p. 977; Reports Chem. Lab., 1909, p. 64; Propaganda, vol. 1, p. 294. Ephedra, Pharmaceutic Preparations of, The Journal, June 22, 1929, p. 2101; Reports Council Pharm. & Chem., 1929, p. Z7. Ephedritone-Inhalant-Massey's (^Nlassev Lab's, Inc."), The Journal, Feb. 22, 1936, p. 617; Reports Council Pharm. & Chem., 1936, p. 26. Ephedrol with Ethylraorphine Hydrochloric (Eli Lilly & Co.), The Journal, March 1, 1930, p. 634; Reports Council Pharm. & Chem., 1930, p. 30. Epinephrin-G. W. C. Co. (G. W. Carnrick Company), The Journal, Jan. 17, 1925, p. 220; Reports Council Pharm. & Chem., 1925, p. 19. Episan (Gaynor-Bagstad Co.), The Journal, Sept. 25, 1915, p. 1130; Reports Council Pharm. & Chem.. 1915. p. 164. Ergoapiol (Martin H. Smith Co.), The Journal, Dec. 12, 1914, p. 2149; Reports Council Pharm. & Chem., 1914, p. 64; Propaganda, vol. 1, p. 82. Ergofortis (Borroughs Bros. Mfg. Co.), The Journal, Dec. 31, 1932, p. 2265; Reports Council Pharm. & Chem., 1932, p. 42. Ergone (Parke, Davis & Co.), The Journal, Oct. 7, 1911, p. 1211; Oct. 14, 1911, p. 1302. Ergot, Extract of, Purified (See Extract of Ergot Purified). Ergot, Liquor-Mulford (See Liquor Ergot-Mulford). Ergot Preparations Omitted: An Explanation, The Journal, Sept. 7, 1929, p. 769; Reports Council Pharm. & Chem., 1929, p. 27. Ergotin-Merck (Merck & Co.), The Journal, May 4, 1929, p. 1521; Reports Council Pharm. & Chem., 1929, p. 26. Ergotinine Citrate, Reports Council Pharm. & Chem., 1928, p. 28. Ergotole (Sharp & Dohme), The Journal, Oct. 7, 1911, p. 1211; Oct. 14, 1911, p. 1302; May 4, 1929; p. 1521; Reports Council Pharm. & Chem., 1929, p. 26. Ergonovine, The Journal, March 21, 1936, p. 1008; Reports Council Pharm. & Chem., 1936, p. 44. Erpiol, Dr. Schrader (Wm. S. Merrell Chemical Co.), The Journal, June 3, 1911, p. 1670; Reports Council Pharm. & Chem., 1911, p. 18; Propaganda, vol. 1, p. 83. Erysipelas Vaccine No. 1 (G. H. Shei-man), The Journal, Oct. 11, 1924, p. 1184; Reports Council Pharm. & Chem., 1924, p. 57. Erysipelas Vaccine (National Drug Co.), The Journal, June 5, 1929, p. 55; Reports Council Pharm. & Chem., 1928, p. 43. Eskosan (Esko Products Co.), Reports Council Pharm. & Chem., 1923, p. 20. Eskosan Cum Methyl Saliclylate (Esko Products Co.), Reports Council Pharm. & Chem., 1923, p. 20; Reports Chem. Lab., 1923, p. 99. Essence of Pepsine-Fairchild (Fairchild Bros. & Foster), The Journal, June 14, 1930, p. 1919; Reports Council Pharm. & Chem., 1930, p. 28. Esterol (Frederick Stearns & Co.), The Journal. Dec. 16, 1922, pp. 2090, 2102; Reports Council Pharm. & Chem., 1922, p. 30; Reports Chem. Lab., 1921, p. 71. Estivin (Schieffelin and Company), The Journal, Nov. 12, 1921, p. 1595; Jan. 23, 1932, p. 340; Propaganda, vol. 2, p. 466, Ethanesal, The Journal, Sept. 22, 1923, p. 1040. Ether, Anesthesia (Cotton Process) (Du Pont Chemical Works), The Journal, Feb. 21, 1920, p. 544; May 22, 1920, p. 1474; Sept. 22. 1923, p. 1040; Propaganda, vol. 2, p. 41. Ethyl Bromide, Reports Council Pharm. & Chem., 1927, p. 35. Ethyl Bromide-Merck (Merck & Co., Inc.), Reports Council Pharm. & Chem., 1927, p. 35. Eto-So-Trc (T. M. Berry), The Journal, Aug. 5, 1922, p. 492. Eubetin (Aesculap Pharmaceutical & Chemical Co., Inc.), The Journal, May 21, 1932, p. 1808; Reports Council Pharm. & Chem., 1932, p. 44. Euca-Mul (The Edward G. Binz Co.), The Journal, Oct. 29, 1921, p. 1438. xxii BIBLIOGRAPHICAL INDEX Eucodin (Riedel & Co.), Reports Council Phartii. & Chem,, 1922, p. 32. Eu-Med (The Oralee Co.), The Journal, Aug. 11, 1928, p. 397; Reports Council Pharm. & Chem., 1928, p. 30. Eumictine (Geo. J. Wallau, Inc.), The Journal, Feb. 21, 1920, p. 542; Reports Council Pharm. & Chem., 1920, p. 7; Propaganda, vol. 2, p. 262. Eunatrol (C. Bischoflf & Co.), The Journal, Feb. 22, 1908, p. 627. Eupeptic Hypophosphites (Nelson, Baker & Co.), The Journal, Sept. 2, 1916, p. 761; Reports Council Pharm. & Chem., 1916, p. 15; Propa- ganda, vol. 2, p. 83. Euphydigtal (Adolph Hurst, Inc.), The Journal, July 8, 1933, p. 124; Reports Council Pharm. & Chem., 1933, p. 89. Euscopol (Riedel & Co.), Reports Council Pharm. & Chem., 1922, p. 32. Eusoma (Eusoma Pharmaceutical Co.), Reports Council Pharm. & Chem, 1912, p. 38. Exicol (Brooklyn Scientific Products Co.), The Journal, July 16, 1932. p. 224; Reports Council Pharm. & Chem., 1932, p. 45. Expurgo Anti-Diabetes (Expurgo Mfg. Co.), The Journal, Jan. 24, 1914; p. 312; Reports Chem. Lab., 1914, p. 27; Propaganda, vol. 1, p. 299. Expurgo Lapis (Expurgo Mfg. Co.), The Journal, Nov. 8, 1913, p. 1733. Extract of Ergot Purified, The Journal, May 4, 1929, p. 1521; Reports Council Pharm. & Chem., 1929, p. 26. Falls Dietetic Flour (J. G. Falls Co.), Reports Council Pharm. & Chem., 1931, p. 42. False Unicom, The Journal, Nov. 27, 1909, p. 1836; Reports Council Pharm, & Chem., 1909, p. 146; Propaganda, vol. 1, p. 84. Farastan (Farastan Co.), The Journal, Feb. IS, 1930, p. 484; Reports Council Pharm. & Chem., 1930, p. 33. Febrisol (The Tilden Co.), The Journal, June 29, 1912, p. 2043. Febri-Tone (Arthur Peter & Co.), The Journal, Feb. 1, 1908, p. 379. Fellows' Syrup of Hypophosphites (Fellows Medical Mfg. Co.), The Journal, Sept. 2, 1916, p. 760; Feb. 16, 1918, p. 478; Reports Coun- cil Pharm. & Chem., 1916, p. 13; Propaganda, vol. 2, p. 82. Felsol (American Felsol Co.), The Journal, May 28, 1927, p. 1750; Feb. 24, 1934, p. 640. Fermenlactyl (Anglo-American Pharmacal Co., Ltd.), The Journal, Jan. 30, 1909, pp. 372, 397. Fermogen (Diabesan), (Solosan Co.), The Journal, July 29, 1933, p. 389. Ferrassin (Robert Wolheim), The Journal, May 24, 1924, p. 1712; Reports Council Pharm. & Chem., 1924. p. 23. Ferric Arsenite. Soluble, Reports Council Pharm. & Chem., 1912, p. 30. Ferric Cacodylate, Reports Council Pharm. & Chem., 1920, p. 62; Propa- ganda, vol. 2, p. 292. Ferritonic-Woods (William A. Webster Company), The Journal, Oct. 18, 1919, p. 1231. Ferrivine (E. Fougera & Co., Inc.), The Journal, Sept. 8, 1917, p. 841; Reports Council Pharm. & Chem., 1917, p. 49; Propaganda, vol. 2, p. 144. Ferro-Copral Tablets (Brewer & Co., Inc.), The Journal, March 5, 1932, p. 816; Reports Council Pharm. & Chem., 1932, p. 46. Ferro-Mangan-Dieterich (Reinschild Chemical Co.), Reports Council Pharm. & Chem., 1925, p. 23. Ferro-Nux Comp, (American Drug Company, Inc.), Reports Council Pharm. & Chem., 1923, p. 23. Ferro-Sajodin, Reports Council Pharm. & Chem., 1935, p. 65. Figwort, Reports Council Pharm. & Chem., 1912, p. 42. Filudine (Geo. J. Wallau, Inc.), The Journal, Sept. 18, 1915, p. 1045; Reports Council Pharm. & Chem,, 1915, p. 156; Propaganda, vol. 2, p. 41. Firma-Chloro (Chloro Chemical Corporation), The Journal, Jan. 5, 1924, p. 53; Oct. 16, 1926, p. 1321; Reports Council Pharm. & Chem., 1926, p. 28. Firolyptol Plain (The Tilden Co.), The Journal, Feb. 17, 1917, p. 564; Reports Council Pharm. & Chem., 1917, p. 8; Propaganda, vol. 2, p. 120. BIBLIOGRAPHICAL INDEX xxiii Firolyptol with Kreosote (The Tilden Co.), The Journal, Feb. 17, 1917. p. 564; Reports Council Pharm. & Chem., 1917, p. 49; Propaganda, vol. 2, p. 120. Firwein (The Tilden Co.), The Journal, Feb. 17, 1917, p. 564; Reports Council Pharm. & Chem., 1917, p. 7; Propaganda, vol. 2, p. 119. Fissan Lotion (Walter Lehn), The Journal, July 16, 1932, p. 223; Reports Council Pharm. & Chem., 1932, p. 47. Fissan Oil (Walter Lehn), The Journal, July 16, 1932, p. 223; Reports Council Pharm. & Chem., 1932, p. 47. Fissan Ointment (Walter Lehn), The Journal, July 16, 1932, p. 223; Reports Council Pharm. & Chem., 1932, p. 47. Fissan Ointment-R (Walter Lehn), The Journal, July 16, 1932, p. 223; Reports Council Pharm. & Chem., 1932, p. 47. Fissan Powder (Walter Lehn), The Journal, July 16, 1932, p. 223; Reports Council Pharm. & Chem., 1932, p. 47. Fissan Soap (Walter Lehn), The Journal, July 16, 1932, p. 223; Reports Council Pharm. & Chem., 1932, p. 47. Fissan Sulfur Powder (Walter Lehn), The Journal, July 16, 1932, p. 223; Reports Council Pharm. & Chem., 1932, p. 47. Fissan Sweat Absorbing Powder (Walter Lehn), The Journal, July 16, 1932, p. 223; Reports Council Pharm. & Chem., 1932, p. 47. Fleischmann's Yeast (The Fleischmann Company), The Journal, May 12, 1923, p. 1398; Reports Council Pharm. & Chem., 1923, p. 23. Fluorated Tricalcine (Laboratories des "Produits Scientia"), The Jour- nal, March 14, 1925, p. 836; Reports Council Pharm. & Chem., 1925, p. 80. Folliculin Menformon (Organon Laboratories), The Journal, Aug. 31, 1935, p. 667. Follutein (E. R. Squibb & Sons), The Journal, Aug. 31, 1935, p. 667. Foral (Foral Products Co.), Reports Council Pharm. & Chem., 1918, p. 55; Propaganda, vol. 2, p. 204. For-Dyne (First Texas Chemical Mfg. Co.), The Journal, Aug. 3, 1935, p. 387. Formaldehyde Lozenges, The Journal, Oct. 4, 1919, p. 1077; Reports Council Pharm. & Chem.. 1919, p. 32; Propaganda, vol. 2, p. 238. Formamint (A. Wulfing & Co.), The Journal, Jan. 27, 1912, p. 295; Feb. 24, 1912, p. 572; Aug. 28, 1915, p. 816; Reports Council Pharm. & Chem., 1915, p. 64; Propaganda, ed. 9, p. 303; Propa- ganda, vol. 2, p. 33. Formic Acid, Reports Council Pharm. & Chem., 1921, p. 25. Formicin (Kalle Color Chemical Co.), Reports Council Pharm. & Chem.. 1919, p. 76. Formidin (Parke, Davis & Co.), The Journal, Sept. 5, 1908, p. 818; Reports Council Pharm. & Chem., 1905-8, pp. 164, 192; 1912, p. 48. Formitol Tablets (E. L. Patch Co.), The Journal. Oct. 4, 1919, p. 1077; June 19, 1920, p. 1730; Reports Council Pharm. & Chem., 1919, p. 34; 1920. p. 20; Reports Chem. Lab., 1920, p. 40; Propaganda, vol. 2, pp. 236, 271. Formosol, Sunshine's (The Formosol Chemical Co.), Reports Council Pharm. & Chem., 1917, p. 145; Propaganda, vol. 2, p. 158. Formothalates, Tablets (Tailby Nasan Company), Reports Council Pharm. & Chem., 1919, p. 92; Propaganda, vol. 2, p. 256. Formurol (Cellarius Co.), The Journal, Jan. 21, 1911, p. 210; Reports Council Pharm. & Chem., 1911, p. 7; Propaganda, vol. 1, p. 85. Fortossan (A. Klipstein & Co.), The Journal, Jan. 30, 1915, p. 456; Reports Council Pharm. & Chem., 1915, p. 131; Propaganda, vol. 1, p. 178. Fosfoplasmina (Neother Products Co.), The Journal, June 21, 1924, p. 2068; Reports Council Pharm. & Chem., 1924, p. 11. Frenly Enema Cream (Frenly Products Co.), The Journal, Sept. 19, 1931, p. 852; Reports Council Pharm. & Chem., 1931, p. 44. Friedlander Bacillus Vaccine, Reports Council Pharm. & Chem., 1919, p. 78. Friedlander Vaccine No. 36 (G. H. Sherman), The Journal, Oct. 11, 1924, p. 1184; Reports Council Pharm. & Chem., 1924, p. 57. Fringe Tree, Reports Council Pharm. & Chem., 1912, p. 42. Frutosen (The Frutosen Drug Co.). Reports Council Pharm. & Chem., 1921, p. 26. xxiv BIBLIOGRAPHICAL INDEX Gadoment (E. L. Patch Co.), The Jourxal, Oct. 24, 1936, p. 1384; Reports Council Pharm. & Chem., 1936, p. 34. G. G. Phenoleum Disinfectant (G. G. Phenoleum Co., Inc.), Thb Journal, Jan. 30, 1915, p. 456; Reports Council Pharm, & Chem., 1915, p. 131. Galactagogue (Eli Lilly & Co.), Reports Council Pharm. & Chem., 1912, p. 43. Galactenzyme Tablets (Fairchild Bros. & Foster), The Journal, June 4, 1927, p. 1831; Reports Council Pharm. & Chem., 1927, p. 20. Galyl (Geo. G. Wallau, Inc.), The Journal, Nov. 11, 1922, p. 1706; Reports Council Pharm. & Chem., 1922, p. 34; Reports Chem. Lab., 1922, p. 40. Gambir-Agar (Reinschild Chemical Co.), The Journal, Nov. 12, 1932, p. 1690; Reports Council Pharm. & Chem., 1932, p. 57. "Gan-Aiden" (Fantazn Laboratories), The Journal, Nov. 26, 1932, p. 1863; Reports Council Pharm. & Chem., 1932, p. 51. Gastrogen Tablets (Bristol-Myers Co.), The Journal, Dec. 12, 1914, p. 2149; Reports Council Pharm. & Chem., 1914, p. 131; Propa- ganda, vol. 1, p. 87. Gastron (Fairchild Bros. & Foster), The Journal, June 14, 1930, p. 1919; Reports Council Pharm. & Chem., 1930. p. 28. Gelobarin (Powers-Weightmann-Rosengarten Co.), The Journal, Sept. 17, 1927, p. 984; Reports Council Pharm. & Chem., 1927, p. 36. Gelsemine Hydrochlorid, Reports Council Pharm. & Chem., 1911, p. 57. Gelseminine, Reports Council Pharm. & Chem., 1911, p. 57. Genitone (Wm. S. Merrcll Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 44. Genoform (C. Bischoff & Co.), The Journal, Feb. 26, 1916, p. 676. Germanin, See Bayer-205, Germanium Dioxide, See Geroxide. Germaseptic Lubricant "Bing" (Chas. M. Griswold, St. Petersburg, Fla.), Reports Council Pharm. & Chem., 1918, p. 79. Gcrmiletum (Dios Chemical Co.), The Journal, Jan. 9, 1915, p. 165; Reports Council Pharm. & Chem., 1914, p. 86; Reports Chem. Lab., 1910, p. 11; Propaganda, vol. 1, p. 139. Geroxide (Germanium Products Co.), The Journal, June 6, 1925, p. 1856; Reports Council Pharm. & Chem., 1925, p. 24. Ginseng, The Journal, Oct. 24, 1914, p. 1486; Reports Council Pharm, & Chem., 1912, p. 42. Ginseng Compound, Elixir (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912. p. 42. Glandular Comp. (Male), Special Formula No. 1 (G. W. Carnrick Co.), The Journal, Feb.^ 28, 1925, p. 695; Reports Council Pharm. & Chem., 1925, p. 85. Glandular Comp. (Female) Special Formula No. 2 (G. W. Carnrick Co.), The Journal, Feb. 28, 1925, p. 695; Reports Council Pharm. & Chem., 1925, p. 85. Glidine (Menley & James), The Journal, June 28, 1913, p. 2037. Globeol (Geo. J. Wallau, Inc.), The Journal, Sept. 18, 1915, p. 1046; Reports Council Pharm. & Chem., 1915, p. 157. Gluco-Dextrin No. 1 (West Mfg. Co.), The Journal, July 13, 1929, p. 117; Reports Council Pharm. & Chem., 1929, p. 28. Gluco-Dextrin No. 2 (West Mfg. Co.), The Journal, July 13, 1929, p. 117; Reports Council Pharm. & Chem., 1929, p. 28. Gluco-Dextrin No. 3 (West Mfg. Co.), The Journal, July 13, 1929, p. 117; Reports Council Pharm. & Chem., 1929, p. 28. "Glucosin" (Dr. A. Casagrande), The Journal, May 21, 1932, p. 1833. Glutamic Acid, Reports Council Pharm. & Chem., 1935, p. 65. Gluten Biscuit, Pure (Kellogg Food Company), Reports (Council Pharm. & Chem., 1916, pp. 56, 57; Propaganda, vol. 2, p. 100. Gluten Biscuit, 40 per cent (Kellogg Food Company), Reports Council Pharm. & Chem., 1916, pp. 56, 58; Propaganda, vol. 2, p. 100. Gluten Biscuit, 40 per cent (Kellogg Food Company), Reports Council Pharm. & Chem., 1916, pp. 56, 59; Propaganda, vol. 2, p. 100. Gluten Flour, F. & R.'s Genuine, 40 per cent (Farwell & Rhines), The Journal, Feb. 14, 1923, p. 533; Reports Council Pharm. & Chem., 1925, p. 22. Gluten Meal, Pure (Kellogg Food Company), Reports Council Pharm. & Chem., 1916, pp. 56, 60; Propaganda, vol. 2, p. 100. BIBLIOGRAPHICAL INDEX xxv Gluten Meal, 40 per cent (Kellogg Food Company), Reports Council Pharm. & Chem., 1916, pp. 56, 60; Propaganda, vol. 2, p. 100. Gluten Meal, 40 per cent (Kellogg Food Company), Reports Council Pharm. & Chem., 1916, pp. 56, 59; Propaganda, vol. 2, p. 100. Glutol-Schleich (Schering & Glatz, Inc.), Reports Council Pharm. & Chem., 1915, p. 170. Glycerinated Vaccine Virus (National Vaccine and Antitoxin Institute), Reports Council Pharm. & Chem., 1921, p. 23. Glycerine Tonic, Gray's (Purdue Frederick Co.). The Journal, July 10, 1915, p. 189; Reports Council Pharm. & Chem., 1915, p. 56; Propa- ganda, vol. 2, pp. 24, 249. Glycero-Lecithin, Pill (Westerfield Pharmacal Co.), Reports Council Pharm. & Chem., 1915. p. 170. Glycerole of Lecithin (Fairchild Bros. & Foster), Reports Council Pharm. & Chem.. 1915, p. 122; Propaganda, vol. 2, p. S3. Glycerophosphates, The Journal, Sept. 30. 1916, p. 1033; Reports Council Pharm. & Chem., 1916, p. 32; Propaganda, vol. 2, p. 520. Glycerophosphate Comp. No. 1, Mulford, Ampuls (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1916. p. 49. Glycerophosphate Comp. Ampuls, 1 cc. Squibb (E. R. Squibb & Sons), The Journal, Feb. 3, 1917; Reports Council Pharm. & Chem., 1916, p. 48. Glycerosal (Rohm & Haas), Reports Council Pharm. & Chem., 1918, p. 57. Glyco-Heroin, Smith (Martin H. Smith & Co.), The Journal, June 6, 1914, p. 1826; Reports Council Pharm. & Chem., 1914, p. 29; Propa- ganda, ed. 9, p. 88. Glyco-Pepto Milk (Glyco-Pepto Manufacturing Co., Inc.), The Journal, April 21, 1923, p. 1165; Reports Council Pharm. & Chem., 1923, p. 27. Glyco-Thymoline (Kress & Owen Co.), The Journal, March 14, 1914, p. 868; Oct. 10, 1914, p. 1312; Sept. 16, 1916. p. 895; Reports Council Pharm. & Chem., 1914. p. 54; Propaganda, vol. 1, p. 92. Glycozone (Drevet Mfg. Co.). The Jour?^al, June 5. 1909, p. 1851; Reports Council Pharm. & Chem., 1909, p. 103; Propaganda, vol. 1, p. 95. Glyeuthymol (Nixon, Stuart & Barker), The Journal, Nov. 15. 1924, p. 1606; Reports Council Pharm. & Chem., 1924, p. 24. Gly-So-Dental (National Medical Research Laboratories), The Journal, Dec. 22, 1923, p. 2123; Reports Council Pharm. & Chem., 1923. p. 29. Gly-So-Iodonate (National Medical Research Laboratories), The Jour- nal, Dec. 22, 1923, pp. 2118. 2132; June 7, 1924, p. 1881; Reports Council Pharm. & Chem., 1923, p. 29; Reports Chem. Lab., 1923, p. 87. Goat's Rue, The Journal, May 26, 1917, p. 1570; Reports Council Pharm. & Chem., 1912, p. 42; 1917, p. 24; Propaganda, voL 2, p. 131. Goiter Serum. Mark White (Mark White Serum Laboratories), The Journal, Sept. 23, 1916, p. 967; Reports Council Pharm. & Chem., 1916, p. 23; Propaganda, vol. 2, p. 87. Gomenol (Charles R. Bard), The Journal, April 4. 1914, p. 1110; Propaganda, vol. 1, p. 304. Gonad-Ovarian Compound (Harrower Laboratory, Inc.), The Journal, Oct. 16, 1926, p. 1322. Gonococcic (Neisser) Vaccine (National Drug Co.), Reports Council Pharm. & Chem., 1928, p. 43. Gonococcic Vaccine (National Vaccine and Antitoxin Institute), Reports Council Pharm. & Chem., 1921. p. 53. Gonococcide (Cox Chemical Co.), The Journal, Aug. 24, 1907, p. 708. Gonococcus Antigen No. 35 (Persson Laboratories), Reports Council Pharm. & Chem., 1922, p. 62. Gonococcus Immunogen (Parke, Davis & Co.), The Journal. Sept. 17, 1927, p. 984; Reports Council Pharm. & Chem., 1927, p. 37. Gonococcus Immunogen Combined (Parke, Davis & Co.), The Journal, Sept. 17, 1927, p. 984; Reports Council Pharm. & Chem., 1927, p. 37. Gonococcus Serum, The Journal. Jan. 17, 1925, p. 220; Reports Council Pharm. & Chem., 1924, p. 20. Gonococcus Vaccines, The Journal, Jan. 17, 1925, p. 220; Reports Council Pharm. & Chem., 1924, p. 20. xxvi BIBLIOGRAPHICAL INDEX GonoHn (Horovitz Biochemic Laboratories), The Journal, April 4, 1925, p. 1070; Dec. 21, 1929, p. 1974. Gonosan (Riedel & Co., Inc.), The Journal, Oct. 13, 1917, p. 1287; Reports Council Pharm. & Chem., 1917, p. 57; Propaganda, vol. 2, p. 150. Gossypin, The Journal, June 3, 1911, p. 1670; Reports Council Pharm. & Chem., 1911, p. 19; Propaganda, vol. 1, p. 84. Granular Effervescent Salicylos (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1926, p. 29. Granular Effervescent Sodium Phosphate Compound (Squibb) (E. R. Squibb & Sons), Reports Council Pharm. & Chem., 1920, p. 63. Griffith's Compound Mixture, The Journal, Jan. 21, 1922, p. 236. Guiaialin (Organic Chemical Mfg. Co.), The Journal, Sept. 5, 1908, p. 818; May 8, 1909, p. 1511; Reports Council Pharm. & Chem., 1905-8, p. 166; 1909, p. 76. Guaiodine (Intravenous Products Co.), The Journal, April 6, 1918, p. 1026; Reports Council Pharm. & Chem., 1918, p. 9; Reports Chem, Lab., 1918, p. 24; Propaganda, vol. 2, p. 183. Guaisodide (George A. Breon & Co.), The Journal, Sept. 27, 1924, p. 1021. Guphen (Gane's Chemical Works, Inc.), Reports Council Pharm. & Chem., 1933, p. 95. Gynantrin (G. D. Searle & Co.), The Journal, Aug. 31, 1935, p. 667. H-M-C. : See Hyoscin-Morphin-Cactin. Haelepron Tablets (Haelepron Sales Co.), The Journal, July 22, 1922, p. 319; Reports Council Pharm. & Chem., 1922, p. 38. Hair Cap Moss, Reports Council Pharm. & Chem., 1912, p. 43. Haley's M-0 Magnesia Oil (Haley M-0 Co., Inc.). The Journal, April 5, 1930, p. 1067; Reports Council Pharm. & Chem., 1930, p. 34. Havens' Wonderful Discovery (E. C. Havens), The Journal, March 22, 1919, p. 883; Reports Council Pharm. & Chem., 1919, p. 7. Hay Fever Fall Pollen Extract-Mulford (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1921, p. 45. Hay Fever Spring Pollen Extract-Mulford (H. K. Mulford Co.), Re- ports Council Pharm. & Chem., 1921, p. 45. Hayner's Normaline (Norman C. Hayner Co.), The Journal, Sept. 26, 1931, p. 931; Reports Council Pharm. & Chem., 1931, p. 45. Healthola Diabetic Flour (Healthola Diabetic Flour Co.), The Journal, July 11, 1931, p. 103; Reports Council Pharm. & Chem., 1931, p. 46. Hectine (Geo. J. Wallau. Inc.), The Journal, Aug. 8, 1914, p. 502; Sept. 20, 1924, p. 942; Propaganda, ed. 9, p. 308. Helenin and Globules of "Helenin De Korab" (De Korab Bojemski), Reports Council Pharm. & Chem., 1919, p. 78. Helmitol (Winthrop Chemical Co.), The Journal. Jan. 22, 1921, p. 260; Reports Council Pharm. & Chem., 1920, p. 49; Propaganda, vol. 2, p._ 295. Helonias Compound, Cordial Elixir (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 41. Helonias Compound, Elixir (Hance Bros. & White), Reports Council Pharm. & Chem., 1912,^ p. 41. Helonias Compound, Elixir (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912, p. 41. Helonias Compound, Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 41. Helonias Compound, Elixir (Smith, Kline & French Co.). Reports Coun- cil Pharm. & Chem., 1912, p. 41. Helonias Compound, Fluidextract (Parke, Davis & Co.). Reports Coun- cil Pharm. & Chem.. 1912, p. 41. Hemaboloids (Palisade Manufacturing Co.), Reports Council Pharm. & Chem.. 1919, p. 80. Hemaboloids Arseniated with Strychnia (The Palisade Mfg. Co.), The Journal, Dec. 27, 1913, p. 2306. Hemo (Thompson's Malted Food Co.), The Journal, Oct. 24, 1914, p. 1494; Propaganda, vol. 1, p. 319. Hemo-Therapin (Hemo-Therapin Laboratories), The Journal, Jan. S, 1918, p. 48; Reports Council Pharm. & Chem., 1917, p. 116; Propa- ganda, vol. 2, p. 168. BIBLIOGRAPHICAL INDEX xxvii Hepatex, P. A. F. (Thomas A. Hedley), The Journal, Nov. 13, 1932, p. 1690; Reports Council Pharm. & Chem., 1932, p. 53. Hepatico Tablets (David Laboratories, Inc.), The Journal, Oct. 20, 1917, p. 1734; Reports Council Pharm. & Chem., 1917, p. 64. Hernia, Injection Treatment of, The Journal, Sept. 26, 1936, p. 1053. Hernial (Vincent Ruiz Co.), The Journal, Feb. 1, 1930, p. 339; Reports Council Pharm. & Chem., 1929, p. 31. Herradora's Arsenic Compound for Intravenous Use, Nos. 1 to 6 (Scien- tific Chemical Co.), The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Arsenic and Hypophosphites for Intravenous Use (Scientific Chemical Co.), The Journal, April 28, 1923, p. 1259; Reports Coun- cil Pharm. & Chem., 1923, p. 34. Herradora's Arsenic and Iron Compound for Intravenous Use (Scien- tific Chemical Co.), The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Calcium Compound for Intravenous Use (Scientific Chem- ical Co.), The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem.. 1923. p. 34. Herradora's Calcium-Sodium Glycerophosphate Compound for Intravenous Use (Scientific Chemical Co.), The Journal, April 28, 1923 p. 1259; Reports Council Pharm. 6: (Them., 1923, p. 34. Herradora's Chlorids Compound for Intravenous Use (Scientific Chem- ical Co.), The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Chlorids with Iron Compound for Intravenous Use (Scien- tific Chemical Co.), The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Creosote Compound for Intravenous Use, Nos. 1 and 2 (Scientific Chemical Co.). The Journal, April 28, 1923, p. 1259: Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Digitalin Compound (Scientific (jhemical Co.), The Journal April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923 p. 34. Herradora's Glycerophosphate-Iron and Nickel Compound for Intravenous Use (Scientific Chemical Co.). The Journal, April 28, 1923, p. 1259 Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Guaiacol Compound for Intravenous Use (Scientific Chem; ical Co.), The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem.. 1923. p. 34. Herradora's lodids Compound for Intravenous Use (Scientific Chemical Co.). The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923. p. 34. Herradora's Hexamethylenamine and Guaiacol Compound for Intravenous Use (Scientific Chemical Co.). The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Iron Manganese and Nickel Compov:nd for Intravenous Use (Scientific Chemical Co.). The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Mercury Compound for Intravenous Use (Scientific Chem- ical Co.), The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Quinine Compound for Intravenous Use Nos. 1 and 2 (Sci- entific Chemical Co.), The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Sodium lodid for Intravenous Use (Scientific Chemical Co.). The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Herradora's Sodium lodid-Salicylate-Guaiacol Compound for Intravenous Use (Scientific Chemical Co.), The Journal, April 28, 1923, p. 1259; Reports Council Pharm. & Chem., 1923, p. 34. Heterophile Antibody in the Treatment of Pneumonia, The Journal, Aug. 15, 1936. p. 499. Hexa-Co-Sal-In (Hexa-Co-Sal-In Co.), The Journal, Oct. 2, 1915, p. 1203; Reports Council Pharm. & Chem., 1915, p. 159; Reports Chem. Lab., 1915, p. 107. Hexalet (Riedel & Co.), Reports Council Pharm. & Chem., 1921, p. 27. Hex-a-Iith (Smith-Dorsey Co.), The Journal, Feb. 14, 1914, p. 555. xxviii BIBLIOGRAPHICAL INDEX Hex-Iodin (Daggett and Miller Co., Inc.), The Journal, Oct. 4, 1919, p. 1077; Reports Council Pharm. & Chem., 1919, p. ZZ', Propaganda, vol. 2, p. 236. Hexol (Sanitary Supply Co.), The Journal, Aug. 27, 1927, p. 711; Reports Council Pharm. & Chem., 1927, p. 38. Hexylresorcinol Solution (Sharp & Dohme), The Journal, May 25, 1935, p. 1906; Reports Council Pharm. & Chem., 1935, p. 67. Hogan's Colloid Solution Materials for Intravenous Transfusion. — See Colloid Solution Materials for Intrayenous Transfusion, Hogan's. Holadin (Fairchild Bros. & Foster), The Journal, June 14, 1930, p. 1919; Reports Council Pharm. & Chem., 1930, p. 28. Holadin and Bile Salts, Fairchild (Fairchild Bros. & Foster), Reports Council Pharm. & Chem., 1918, p. 59; Propaganda, vol. 2, p. 207. Holadin, Bile Salts and Phenolphthalein, Capsules of, Fairchild (Fair- child Bros. & Foster), Reports Council Pharm. & Chem., 1918, p 59; Propaganda, vol. 2, p. 208. Holadin, Succinate of Soda and Bile Salts, Capsules of, Fairchild (Fair- child Bros. & Foster), Reports Council Pharm. & Chera., 1918, p 59; Propaganda, vol. 2, p. 208. Homobreol (Organon Laboratories), The Journal, Aug. 31, 1935 p. 1667. Ho-Mo-Sol (Sanizone) (Sanox Co.), The Journal, Aug. 24, 1935 p. 599; Reports Council Pharm. & Chem., 1935, p. 77. Hormotone (G. W. Carnrick Co.). The Journal, Aug. 16, 1919, p. 549; Reports Council Pharm. & Chem., 1919, p. 30; Propaganda, vol. 2 p. 234; Reports Council Pharm. & Chem., 1925, p. 20. Hormotone Without Postpituitary (G. W. Carnrick Co.), The Journal Aug. 16, 1919, p. 549; Reports Council Pharm. & Chem., 1919, p. 30; Propaganda, vol. 2, p. 235. Horse Dung Allergen-Squibb (E. R. Squibb & Sons), The Journal, Nov 7, 1925, p. 1504; Reports Council Pharm. & Chem., 1925, p. 27. Horse Nettle. Reports Council Pharm. & Chem., 1912, p. 43. Horsford's Acid Phosphate (Rumford Chemical Works), The Journal Oct. 7. 1933, p. 1153; Reports Council Pharm. & Chem., 1933, p. 99, Hosal (Abbott Laboratories), The Journal, July 22, 1933, p. 280; Reports Council Pharm. & Chem., 1933, p. 100. Hosept (Homer Laboratories, Inc.), The Journal, Aug. 5, 1933, p. 447; Reports Council Pharm. & Chem., 1933, p. 102. House Dust Allergen-Squibb (E. R. Squibb & Sons)^ The Journal Nov. 7. 1925. p. 1504; Reports Council Pharm. & Chem., 1925, p. 27 Hoyt's Gluten Flakes (Pure Gluten Food Co.), The Journal, Jan. 3 1925, p. 53; Reports Council Pharm. & Chem., 1924, p. 29, Hoyt's Protein Cereal (Pure Gluten Food Co.), The Journal, Nov. 20 1926, p. 1760; Reports Council Pharm. & Ch£m., 1926, p. 30. Hydragogin (C. Bischoff & Co.), The Journal, Jan. 27, 1906, p. 288 Sept. 4, 1915, p. 894; Reports Council Pharm. & Chem., 1915, p. 154; Propaganda, vol. 2, p. 41. Hydrangea and Lithia, Elixir (Hance Bros. & White), Reports Council Pharm. & Chem., 1912, p. 45. Hydrangea, Lithiated (Lambert Pharmacal Co.), Reports Council Pharm. & Chem., 1912, p. 42. Hydras (John Wyeth and Bro.), The Journal, Oct. 7, 1916, p. 1107; Reports Council Pharm. & Chem., 1916, p. Z6', Reports Chem. Lab., 1916, p. 29; Propaganda, vol. 2, p. 96. Hydrastis and Cramp Bark Compound, Elixir (Parke, Davis & Co.), The Journal, Aug. 31, 1912, p. 735; Reports Council Pharm. & Chem., 1912, p. 44; Propaganda, vol. 1, p. 410. Hydrastis and Viburnum Compound, Elixir of (Smith, Kline & French Co.), The Journal, Aug. 31, 1912, p. 735; Propaganda, vol. 1, p. 410. Hydrocyanate of Iron, Tilden (The Tilden Co.), The Journal, June 19, 1909, p. 2008; Reports Chem. Lab., 1909, p. 27; Propaganda, vol. 1, p. 235. Hydroleine (Charles N. Crittenton Co.), Reports Council Pharm. & Chem., 1915, p. 171; Propaganda, vol. 2, p. 58. Hydron (Wm. S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 44. BIBLIOGRAPHICAL INDEX xxix Hydronaphthol (Seabury & Johnson), The Journal, Sept. 3, 1910, p. 878; Reports Chem. Lab., 1910, p. 108; Propaganda, vol, 1, p. 308. Hydropsin (E. Bischoff & Co., Inc.), The Journal, Jan. 8, 1916, p. 135; Reports Council Pharm. & Chem., 1915, p. 94; Propaganda, vol. 2, p. 61. Hydrozone (Charles Marchand), The Journal, Sept. 23, 1905, p. 936; Propaganda, vol. 1, p. 309. Hymosa (Walker Pharmacal Co.), The Journal, June 11, 1910, p. 1955; Reports Chem. Lab., 1910, p. 51; Reports Council Pharm. & Chem., 1912, p. 44; Propaganda, vol. 1, p. 238. Hyoscin-Morphin-Cactin, now Hyoscin-Morphin-Cactoid (The Abbott Lab- oratories), The Journal, Dec. 21, 1907, p. 2103. Hyperol (Purdue Frederick Co.), The Journal, April 18, 1914, p. 1271; Reports Council Pharm. & Chem., 1914, p. 12; Propaganda, vol. 1, p. 100. Hyperthermine (Pasteur Chemical Co.), The Journal, May 19, 1917, p. 1497; Propaganda, vol. 2, p. 331. Hypodermic Solution No. 13, Iron Arsenic and Phosphorus Compound (Burdick-Abel Laboratory), The Journal, Nov. 13, 1920, p. 1358; Reports Council Pharm. & Chem., 1920, p. 27; Propaganda, vol. 2, P- 275. Hypophosphites, The Journal, Sept. 2, 1916, p. 760; Reports Council Pharm. & Chem., 1916, p. 11. Hypophosphites, Robinson's (Robinson-Pettet Company), The Journal, Sept. 2, 1916, p. 761; Reports Council Pharm. & Chem,, 1916, p. 15; Propaganda, vol. 2, p. .83. Hypoquinidol (R. VV. Gardner), The Journal, Jan. 10, 1914, p. 148; Propaganda, vol. 1, p. 310. Ichthalbin (E. Bilhuber, Inc.), The Journal, Feb. 16, 1924; p. 565; Reports Council Pharm. & Chem., 1924, p. 30. Ichthyol (Merck & Co.), The Journal, Feb. 16, 1924, p. 565; Reports Council Pharm. & Chem., 1924, p. 30. Ichthyol-Isapogen (H. Seufert), Reports Council Pharm. & Chem., 1928, p. 34. Ichty-Amon (Meadows Chemical Co.), Reports Council Pharm. & Chem., 1928, p. 12. Ichthynate (Mallinckrodt Chemical Works), Reports Chem. Lab., 1912, p. 110. Ichthytar (Szel Import & Export Co.), The Journal, March 10, 1917, p. 796; Repotrs Council Pharm. & Chem., 1917, p. 18. Idozan (Duomares Corporation), The Journal, April 17, 1926, p. 1233; Reports Council Pharm. & Chem., 1926, p. 31. Igol Oral and Igol G. U. (Surgident Ltd.), The Journal, Sept. 29, 1936, p. 658; Reports Council Pharm. & Chem., 1936, p. 39. Imbak (Ernst W. Abicht), The Journal, Aug. 3, 1935; p. 286; Reports Council Pharm. & Chem., 1935, p. 79. Immune Globulin (Human) : Placimmurjin-Squibb, Reports Council Pharm. & Chem., 1935, p. 81. Immune Globulin (Human) -Lederle, Reports Council Pharm. & Chem., 1935, p. 81. Immunogens (P. D. & Co.) : See Catarrhal Immunogen, Gono- coccus Immunogen, Gonococcus Immunogen Combined, Streptococcus Immunogen, Streptococcus Immunogen Combined, Pertussis Immuno- gen, Pertussis Immunogen Combined, Pneumococcus Immunogen and Pneumococcus Immunogen Combined. Incitamin (Lehn & Fink, Inc.), The Journal, Dec. 12, 1925, p. 1907; Reports Council Pharm. & Chem., 1925, p. 28. Influenza Mixed Vaccine-Lilly (Eli Lilly & Co.), The Journal, June 22, 1918, p. 1967; Reports Council Pharm. & Chem., 1918, p. 11; Propaganda, vol. 2, p. 187. Influenza Prophylactic-Lederle (Lederle Antitoxin Laboratories), Reports Council Pharm. & Chem., 1919, p. 81. Influenza Serobacterin Mixed-Mulford (H. K. Mulford Co.), The Jour- nal, June 22, 1918, p. 1967; Jan. 26, 1929, p. 316; Reports Council Pharm. & Chem., 1918, p. 1967; Jan. 26, 1929, p. 316; Reports Council Pharm. & Chem., 1918, p. 11; Propaganda, vol. 2, p. 187. XXX BIBLIOGRAPHICAL INDEX Influenza Vaccine No. 38 (G. H, Sherman), The Journal, Oct. 11, 1924, p. 1184; Jan. 26, 1929, p. 316; Reports Council Pharm. & Chem., 1924, p. 57. Ingluvin (Wm. R. Warner & Co.), The Journal, July 11, 1908, p. 142; Reports Council Pharm. & Chem., 1905-8, p. 116; Propaganda, vol. 1, p. 101. Injectable Ovarian Preparations, The Journal, Jan. 30, 1932, p. 402; Reports Council Pharm. & Chem., 1932, p. 55. Insoloid (Insurol Co. of America), The Journal, Jan. 31, 1931, p. 377. Insulols (Drug Products Co.), The Journal, July 26, 1924, p. 289. Intarvin (The Intarvin Co.), Reports Council Pharm. & Chem., 1932, p. 55. Interferin, The Journal, Oct. 12, 1935, p. 1210. Interol (Van Horn & Sawtell), The Journal, July 10, 1915, p. 175. Intestinal Antiseptic W-A (The Abbott Laboratories), The Journal, Dec. 19, 1914, p. 2247; Reports Council Pharm. & Chem., 1914, p. 78; Propaganda, vol. 1, p. 103. Intramine (E. Fougera & Co., Inc.), The Journal, Sept. 8, 1917, p. 841; Reports Council Pharm. & Chem., 1917, p. 49; Propaganda, vol. 2, p. 144. Intramuscular Iron Arsenic Comp. (No. 201) (Sci-Medico, Inc.), The Journal, Dec. 7, 1929, p. 1809; Reports Council Pharm. & Chem., 1929, p. 33. Intravenin P-H (Intravenin Products Co.), Reports Council Pharm. & Chem., 1915, p. 120. Intravenous Compound (Loffler) (Charles Lyman Loffler), The Journal, No. 12, 1921, p. 1591; Propaganda, vol. 2, p. 430. (Intravenous) Iron, Cacod. and Glycerophosphate (No. 202) (Sci-Medico, Inc.), The Journal. Dec. 7, 1929, p. 1809; Reports Council Pharm. & Chem., 1929, p. 33. Inyecciones Proliferantes Obturadoras Del Dr. E. Pina Mestre (See Hernial), lodagol (David B. Levy, Inc.), The Journal, Nov. 17, 1917, p. 1725; Reports Council Pharm. & Chem., 1917, pp. 65-116; Reports Chem. Lab., 1917, p. 80; Propaganda, vol. 2, p. 154. lodalia (Geo. J. Wallau, Inc.), The Journal, Dec. 12, 1914, p. 2149; Reports Council Pharm. & Chem., 1914, p. 69; Reports Chem. Lab., 1914, p. 75; Propaganda, vol. 1, p. 106. lodeol (David B. Levy, Inc.), The Journal, Nov. 17, 1917, p. 1725; Reports Council Pharm, & Chem., 1917, pp. 65-116; 1924, p. 41; Reports Chem. Lab., 1917, p. 80; Propaganda, vol. 2, p. 154. lodex (Menley & James), The Journal, Nov. 30, 1912, p. 1992; June 19, 1915, p. 2085; May 3, 1919, p. 1315; April 30, 1927, p. 1438; Reports Council Pharm. & Chem., 1915, p. 144; Reports Chem. Lab., 1915, p. 89; 1919, p. 104; Propaganda, vol. 1, p. 107; Propaganda, vol. 2, pp. 365, 436. lodex, Liquid (Menley & James), Reports Chem. Lab., 1919, p. 104; Propaganda, vol. 2, p. 365. lodia (Battle & Co.), The Journal, Nov. 21, 1914, p. 1871; Reports Council Pharm. & Chem., 1914, p. 60; Reports Chem. Lab., 1914, p. 58; Propaganda, vol. 1, p. 108. lodin, Burnham's Soluble (Burnham Soluble lodin Co.), The Journal, March 28, 1908, p. 1055; May 15, 1915, p. 1673; Reports Council Pharm. & Chem., 1915, p. 50; Reports Chem. Lab., to 1909, p. 30; Propaganda, vol. 1, pp. 110, 233. lodin Petrogen (John Wyeth & Bro.), The Journal, Nov. 30, 1912, p. 1992. lodin Tablets, Burnham's Soluble (Burnham Soluble lodin Co.), The Journal, March 28, 1908, p. 1055; Reports Chem. Lab., to 1909, p. 32; Propaganda, vol. 1, p. 233. Iodine Boric Acid Dusting Powder (Sulzberger) (George P. Pilling Co.), Reports Council Pharm. & Chem., 1934, p. 63. Iodine Ointment, Burnham's (Burnham Soluble Iodine Co.), The Journal, July 1, 1933, p. 33; Reports Council Pharm. & Chem., 1933, p. 26. lodinized Emulsion (Scott) (Dawson Pharmacal Co.), The Journal, Aug. 24, 1918, p. 680; Reports Council Pharm. & Chem., 1918, p. 25; Propaganda, vol. 2, p. 192. BIBLIOGRAPHICAL INDEX xxxi lodinized Oil, Mark White (Mark White Laboratories), The Journal, Sept. 23, 1916, p. 967; Reports Council Pharm. & Chem., 1916, p. 23; Propaganda, vol. 2, p. 87. lodinol (Toledo Pharmacal Co.), The Journal, Aug. 20, 1921, p. 637; Reports Chem. Lab., 1921, p. 31. lodiphos (Charles L. Heffner), Reports Council Pharm. & Chem., 1919, p. 81; Propaganda, vol. 2, p. 249. lodipin 10 Per Cent (Merck & Co., Inc.), Reports Council Pharm. & Chem., 1930, p. 40. lodipin 40 Per Cent (Merck & Co., Inc.), Reports Council Pharm. & Chem., 1930, p. 40. lodival (Knoll & Co.). The Journal, March 4, 1911, p. 685. lod-Izd-Oil (Miller's) (lodum-Miller Co.), The Journal, Oct. 2, 1915, p. 1202; Reports Council Pharm. & Chem., 1915, p. 76; Reports Chem. Lab., 1915, p. 106; Propaganda, vol. 2, p. 49. lodochlorol (G. D. Searle & Co.), The Journal, May 26, 1934, p. 1761; Reports Council Pharm. & Chem., 1934, p. 65. lodochlorol Emulsion (G. D. Searle & Co.), The Journal, May 26, 1934, p. 1761; Reports Council Pharm. & Chem., 1934, p. 65. lodobor (lodobor Co.), Reports Council Pharm. & Chem., 1930, p. 41; 1934, p. 63. lodo-Bromide of Calcium Comp., "Without Mercury" and "With Mer- cury," Elixir (The Tilden Co.), The Journal, Nov. 6, 1915, p. 1662; Reports Council Pharm. & Chem., 1915, p. 160. lodo-Mangan (Reinschild Chemical Co.), Reports Council Pharm. & Chem., 1916, p. 64; Propaganda, vol. 2, p. 106. lodomin (American Bio-Chemical Laboratories, Inc.), The Journal, May 27, 1933, p. 1687; Reports Council Pharm. & Chem.. 1933. p. 113. Idomuth (Organic Chemical Mfg. Co.), The Journal, Sept. 5, 1908, p. 818; May 8, 1909, p. 1511; Reports Council Pharm. & Chem., 1905-8, p. 166; 1909, p. 75. lodonucleoid (Dinet & Delfosse Pharm. Co.), The Journal, July 22, 1911, p. 309; Reports Chem. Lab., 1911, p. 92; Propaganda, vol. 1, p. 310. lodotone (Eimer & Amend), The Journal, Dec. 12, 1914, p. 2149; Reports Council Pharm. & Chem., 1914, p. 72; Propaganda, vol. 1, p. 113. lodovasogen (Lehn & Fink), The Journal, Feb. 13, 1909, p. 575; Propa- ganda, ed. 9, p. 408. lodoxybenzoates. The Journal, March 19, 1932, p. 983; Reports Council Pharm. & Chem., 1932, p. 56. lodyl (The Vel Co.), The Journal, May 14, 1932, p. 1744; Reports Council Pharm. & Chem., 1932, p. 57. lodum-Miller (lodum-Miller Co.). The Journal, Oct. 2, 1915, p. 1202; Reports Council Pharm. & Chem., 1915, p. 76; Reports Chem. Lab., 1915, p. 102; Propaganda, vol. 2, p. 49. lomer-Mensal (National Medical Research Laboratories), The Journal, Dec. 22, 1923, p. 2123; Reports Council Pharm. & Chem., 1923, p. 29. losaline (losaline Co., Inc.), The Journal, March 15, 1913, p. 849, July 21, 1928, p. 173; Reports Council Pharm. & Chem., 1913, p'. 13, 1928, p. 32; Propaganda, vol. 1, p. 113. Ipecacuanha-Agar (Reinschild Chemical Co.), Reports Council Pharm. & Chem., 1934, p. 66. Iridinol (P. H. Potter & Sons, Inc.), The Journal, Nov. 24, 1923, p. 1807; Reports Council Pharm. & Chem., 1923, p. 46. Iron Arsenic Comp. (No. 201), Intramuscular (See Intramuscular Iron Arsenic Comp. No. 201). Iron, Cacod. and Glycerophosphate (No. 202) (Intravenous) (See Intra- venous Iron, Cacod. and Glycerophosphate). Iron Solution for Intravenous Therapy-Perkins and Ross (Perkins & Ross), The Journal, Nov. 14, 1914, p. 1778; Reports Council Pharm. & Chem., 1914, p. 125. Iron Tropon (Tropon Works), The Journal, April 23, 1910, p. 1389; Propaganda, vol. 1, p. 313. Isapogen (H. Seufert), Reports Council Pharm. & Chem., 1928, p. 34 xxxii BIBLIOGRAPHICAL INDEX Isopral (The Bayer Company, Inc.), The Journal, Aug. 8, 1908, p. 487; Reports Council Pharm. & Chem., 1905-8, p. 119. Isopropyl Alcohol, The Journal, Feb. 15, 1936, p. 562. Ittiolo (Guiseppi W. Guidi), Renorts Council Pharm. & Chem., 1920, p. 64. I-X Barium Meal (Dick X-Ray Co.), The Journal, March 24, 1934, p. 930; Reports Council Pharm. & Chem., 1934, p. 67. I-X Barium Meal (Unflavored) (Dick X-Ray Co.), The Journal, March 24, 1934, p. 930; Reports Council Pharm. & Chem., 1934, p. 67. Jaroma (Jaroma Co.), The Journal, Sept. 2, 1911, p. 835; Reports Chem. Lab., 1911, p. 103. Jelcolon (Colonic Jelly, Inc.), Reports Council Pharm. & Chem., 1930, p. 42. Jubol (Geo. J. Wallau, Inc.), The Journal, Aug. 14, 1915, p. 639; Reports Council Pharm. & Chem., 1915, p. 152; Propaganda, vol. 2, p. 31. Juglandin, The Journal, Nov. 13, 1909, p. 1655; Reports Council Pharm. & Chem., 1909, p. 135. Junicosan (Hans P. Wesemann), Reports Council Pharm. & Chem., 1923, p. 48. Kalak Water (Kalak Water Co., Inc.), Reports Council Pharm. & Chem., 1917, p. 148; 1922, p. 39; Propaganda, vol. 2, p. 160; Reports Council Pharm. & Chem., 1928, p. 37. Kal Pheno Tcoth Paste (Kal Pheno Chemical Co.), Reports Council Pharm. & Chem., 1921, p. 41. Kal Pheno Tooth Powder (Kal Pheno Chemical Co.), Reports Council Pharm. & Chem., 1921. p. 41. Kalzan (Wulfing Co.), The Journal, April 7, 1928, p. 1117; Reports Council Pharm. & Chem., 1928, p. 38. Katharmon (Katharmon Chemical Co.). The Journal, Aug. 10, 1918, p. 487; Reports Council Pharm. & Chem., 1918, p. 23; Reports Chem. Lab., 1918, p. 35; Propaganda, vol. 2, p. 191. Kefilac (Kefilac Co.), The Journal, Jan. 30, 1909, pp. 372, 397. Kefir Fungi, The Journal, July 1, 1933, p. 34; Reports Council Pharm. & Chem., 1933, p. 21. Kelpidine — See Minson's Soluble lodin. Keraphen (Picker X-Ray Corp.), The Journal, June 26, 1929, p. 2171; Reports Council Pharm. & Chem.. 1929, p. 34. Kerasol (Picker X-Ray Corp.), The Journal, June 26, 1929, p. 2171; Reports Council Pharm. & Chem., 1929, p. 34. Keratin, Reports Council Pharm. & Chem., 1911, p. 58. Kerolysin f Upjohn Co.), The Journal, May 20, 1933, p. 1597; Reports Council Pharm. & Chem., 1933, p. 31. Kidney Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Kinazyme (G. W. Carnrick Co.), The Journal, Nov. 1, 1913, p. 1649. Ki-Uma (E. Fougera), The Journal, June 10, 1933, p. 1885. Kola Compound, Elixir (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912, p. 40. Kola Compound, Elixir (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 40. Kolynos (Kolynos Co.), The Journal, Nov. 15, 1913, p. 1812. Kondremul (Plain) (E. L. Patch Co.), The Journal, Aug. 5, 1933, p. 447; Reports Council Pharm. & Chem., 1933, p. 118. Kondremul with Phenolphthalein (E. L. Patch Co.), The Journal, Aug. 5, 1933, p. 447; Reports Council Pharm. & Chem., 1933, p. 118. Konsyl (Burton, Parsons & Co.), The Journal, Dec. 5, 1936, p. 1891; Reports Council Pharm. & Chem., 1936, p. 42. Kora-Konia (Gerhard Mennen Chemical Co.), The Journal, Sept. 30, 1916, p. 1034; Reports Council Pharm. & Chem., 1916, p. 31; Reports Chem. Lab., 1916, p. 26; Propaganda, vol. 2, p. 92. Koyol (The Koyol Co.), Reports Council Pharm. & Chem., 1915, p. 172. Kutnow's Powder (Kutnow Bros.), The Journal, Nov. 9, 1907, p. 1619; Propaganda, ed. 9, p. 314. BIBLIOGRAPHICAL INDEX xxxiii Labordine (Labordine Pharmacal Co.), The Journal, March 30, 1907, p. 1121; Reports Council Pharm. & Chem., 1905-8, p. 45; 1912, p. 40; Propaganda, vol. 1, p. 115. Lactampoule (Fairchild Bros. & Foster), The Journal, June 4, 1927, p. 1831; Reports Council Pharm. & Chem., 1927, p. 20. Lacteol (Dr. Boucar, Paris), The Journal, Dec. 21, 1916, p. 1959. Lactic Bacillary Tablets-Fairchild (Fairchild Bros. & Foster), The Jour- nal, June 4, 1927, p. 1831; Reports Council Pharm. & Chem., 1927, p. 20. Lactobacilline (The Franco- American Ferment Co.), The Journal, April 17, 1915, p. 1346; Sept. 18, 1915, p. 1049; Reports Council Pharm. & Chem,, 1915, p. 143; Propaganda, vol. 1, p. 120. Lactobacillus Acidophilus Milk (Towt) (Towt-Nolan Laboratory), The Journal, April 4, 1936, p. 1165; Reports Council Pharm. & Chem., 1936, p. 42, Lacto-Kelpol (Kelpol Laboratories), The Journal, Oct. 10, 1931, p. 1077; Reports Council Pharm. & Chem., 1931, p. 61. Lactone (Parke, Davis & Co.), The Journal, Jan. 30, 1909, pp. 372, 397. Lactopeptine (New York Pharmacal Association), The Journal, March 16, 1907, p. 959; Aug. 2, 1913, p. 358; Oct. 23, 1915, pp. 1466, 1467, 1477; Reports Council Pharm. & Chem., 1905-8, p. 43; 1913, p. 21; 1915, p. 79; Propaganda, vol. 1, p. 121; Propaganda, vol. 2, p. 43. Lactopeptine, Elixir (New York Pharmacal Association), The Journal, Feb. 9, 1907, p. 533; Oct. 23, 1915, pp. 1466, 1467, 1477; Reports Council Pharm. & Chem., 1915, p. 79; Propaganda, vol. 2, p. 43. Lactucarium, Aubergier's Syrup of (E. Fougera & Co., Inc.), The Journal, Nov. 9, 1912, p. 1732; Feb. 15, 1913, p. 538; Propaganda, vol. 1, p. 399, La Mercy Mineral Water (McKesson & Robbins, Inc.), The Journal, June 22, 1933, p. 280; Reports Council Pharm. & Chem., 1933, p. 119. La Mond's Prescription (H. M. Fletcher), Reports Council Pharm. & Chem,. 1930, p. 42. Larostidin-Roche (Hoffraann-LaRoche), The Journal, April 25, 1936, p, 1473. Lavoris (Lavoris Chemical Company). The Journal, Nov. 1, 1919, p. 1380; Reports Council Pharm. & Chem., 1919, p. 35; Reports Chem. Lab., 1919, p. 53; Propaganda, vol. 2, p. 237. Laxaphen (Parke, Davis & Co.), The Journal, April 30, 1910, p. 1458; Propaganda, vol. 1, p. 344. Laxine (Columbus Pharmacal Co.), The Journal, April 30, 1910, p. 1458; Propaganda, vol. 1, p. 344. Laxothalen Tablets (Pitman-Moore Co.), The Journal, April 30, 1910, p, 1458; Propaganda, vol. 1, p, 344. Lecibrin (Fairchild Bros. & Foster), Reports Council Pharm. & Chem., 1915, p. 122; Propaganda, vol. 2, p. 53. Lecithin, Reports Council Pharm. & C^hem., 1915, p. 122; Propaganda, vol, 2, p. 53. Lecithine, (jare's Granular (Gare Pharmacal Co.), Reports Council Pharm. & Chem., 1916, p. 56. Lecithin Solution (Fairchild Bros. & Foster), Reports Council Pharm. & Chem., 1915, p. 122; Propaganda, vol. 2, p. 53. Lecithol (Armour & Co.), Reports Council Pharm. & Chem., 1915, p. 122; Propaganda, vol. 2, p. 53. Lens Antigen, The Journal, April 14, 1928, p. 1239. Lens Extract (H. K. Mulford). The Journal, June 9, 1928, p. 1879; Reports Council Pharm. & Chem., 1928, p. 40. Le Page's Glue Allergen-Squibb (E. R. Squibb & Sons), The Journal, Nov. 7, 1925, p. 1504; Reports Council Pharm. & Chem., 1925, p. 27. Lesol (Southwest Medical Supply Co.), The Journal, Dec. 20, 1930, p, 1933, Lettuce Calmative (Nelson, Baker & Co.), Reports Council Pharm. & Chem., 1912, p. 43. Lettuce, Wild, Reports Council Pharm. & Chem., 1912, p. 43. Leucotropin (Morgenstern & Co.), The Journal, Jan. 3, 1925, p. 56. Leucocytic Extract, Archibald's (The Western Laboratories), Reports Council Pharm. & Chem., 1916, p. 65. xxxiv BIBLIOGRAPHICAL INDEX Leukocyte Extract (E. R. Squibb & Sons), Reports Council Pharm. & Chem., 1922, p. 43. Leukocyte Extract, Reports Council Pharm. & Chem., 1922, p. 43, Leventis' Humanized Serum, The Journal. Sept. 29, 1928, p. 980. Libradol (Lloyd Bros.), Reports Council Pharm. & Chem., 1920, p. 65; Propaganda, vol. 2, p. 293. Lignasin (du Pont de Nemours Co.), The Journal, June 3, 1933, p. 1795. Lilly's Solution, Dental: See Dental Solution, Lilly's. Lipoidal Substances (Horovitz) (Horovitz Biochemic Laboratories Co.), The Journal, Feb. 25, 1922, p. 600; Reports Council Pharm. & Chem., 1922, p. 44; Propaganda, vol. 2, p. 320. Liposan (HoflFman & Hicks), The Journal, May 3, 1924, p. 1462; Reports Council Pharm. & Chem., 1925, p. 30. Liquid Peptone (Eli Lilly & Co.), The Journal^ May 11, 1907, p. 1612; Reports Council Pharm. & Chem., 1905-8, opp. p. 64; Propaganda, vol. 1, p. 133. Liquid Peptone (Stevenson & Jester Co.), The Journal, May 11, 1907, p. 1612; Reports Council Pharm. & Chem., 1905-8, opp. p. 64; Propa- ganda, ed. 9, p. 133. Liquid Peptones with Creosote (Eli Lilly & Co.), The Journal, May 11, 1907; p. 1612; Reports Council Pharm. & Chem., 1905-8, opp. p. 64; Propaganda, vol. 1, p. 133. Liquid Peptonoids (Arlington Chemical Co.), Reports Council Pharm. & Chem., 1922, p. 48. Liquor Ergot-Mulford (H. K. Mulford Co.), The Journal, May 4, 1929, p. 1521; Reports Council Pharm. & Chem., 1929, p. 26. Liquor Santaiva, S. & D. (Sharp & Dohme), Reports Council Pharm. & Chem., 1918, p. 66; Propaganda, vol. 2, p. 211. Listerine (Lambert Pharmacal Co.), The Journal, July 4, 1925, p. 55; April 18, 1931, pp. 1303, 1308. Lithia and Hydrangea, Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 45. Lithia and Hydrangea, Elixir (Ray Chemical Co., Reports Council Pharm. & Chem., 1912, p. 45. Lithia and Hydrangea, Elixir (Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912. p. 45. Lithiated Hydrangea (Lambert Pharmacal Co.), The Journal, July 4, 1925, p. 55. Lithiated Sorghum Compound (Sharp & Dohme), Reports Council Pharm. & Chem., 1912, p. 39. Lithium Salts. Reports Council Pharm. & Chem., 1935, p. 89. Lithontriptic, The Journal, Feb. 28, 1925, p. 699. Liver Leaf, Reports Council Pharm. & Chem., 1912, p. 43. Liver Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. L. O. Compound No. 1 and No. 2 (Medical Supply Co.), Reports Coun- cil Pharm. & Chem., 1917, p. 156; Propaganda, vol. 2, p. 163. Loeflund's Food Maltose (Britt, Loeffler & Weil), The Journal, Jan. 17, 1925, p. 220; Reports Council Pharm. & Chem., 1924, p. 45. Loeflund's Malt Extract with Calcium (Britt, Loeffler & Weil), Reports Council Pharm. & Chem., 1929, p. 35. Loeflund's Malt Extract with Cod Liver Oil (Britt, Loeffler & Weil), Reports Council Pharm. & Chem., 1930, p. 45. Loeser's Intravenous Solution of Calcium Chloride (New York Intra- venous Laboratory, Inc.), The Journal. March 21, 1925, p. 914; Jan. 16, 1926, p. 217; Reports Council Pharm. & Chem., 1925, pp. 31, 22. Loeser's Intravenous Solution of Hexamethylenamin (New York Intra- venous Laboratory, Inc.), The Journal, April 16, 1921, p. 1120; Reports Council Pharm. & Chem., 1921, p. 43; Propaganda, vol. 2, p. 299. Loeser's Intravenous Solution of Hexamethylenamin and Sodium Iodide (New York Intravenous Laboratory, Inc.). The Journal, April 16, 1921, p. 1120; Reports Council Pharm. & Chem., 1921, p. 43; Prop^ ganda, vol. 2, p. 299. BIBLIOGRAPHICAL INDEX xxxv Loeser's Intravenous Solution of Mercury Bichloride (New York Intra- venous Laboratory, Inc.), The Journal, April 16, 1921, p. 1120; Reports Council Pharm. & Chem., 1921, p. 43; Propaganda, vol. 2, p. 299. Loeser's Intravenous Solution of Salicylate and Iodide (New York Intravenous Laboratory, Inc.), The Journal, April 16, 1921, p. 1120; Reports Council Pharm. & Chem., 1921, p. 43; Propaganda, vol. 2, p. 299. Loeser's Intravenous Solution of Sodium Iodide (New York Intravenous Laboratory, Inc.), The Journal, April 16, 1921, p. 1120; Reports Council Pharm. & Chem., 1921, p. 43; Propaganda, vol. 2, p. 299. Loeser's Intravenous Solution of Sodium Salicylate (New York Intra- venous Laboratory, Inc.), The Journal, April 16, 1921, p. 1120; Reports Council Pharm. & Chem., 1921, p. 43; Propaganda, vol. 2, p. 299. Loeser's Intravenous Solution of Sodium Thiosulfate (New York Intra- venous Laboratory Inc.), The Journal, April 28, 1925, p. 1289; Jan. 16, 1926, p. 217; Reports Council Pharm. & Chem., 1925, pp. 32, 33. Lucas Laboratories' Products (Lucas Laboratories, Inc.), The Journal, Sept. 20, 1919, p. 927; Propaganda, vol. 2, p. 440. Luesol (Horovitz Biochemical Laboratories), The Journal, Dec. 21, 1929, p. 1974. Luetin, Reports Council Pharm. Chem., 1922, p. 49. Luetin (H. K. Mulford & Co.), Reports Council Pharm. & Chem., 1922, p. 49. Lukosine (National Drug Co.), The Journal, Feb. 19, 1927, p. 588; Aug. 13, 1927, p. 542; Reports Council Pharm. & Chem., 1927, p. 40-41. Lumodrin (Winthrop Chemical Co.), The Journal, April 15, 1933, p. 1172; Reports Council Pharm. & Chem., 1933, p. 121. Lupulin-Agar (Reinschild Chemical Co.), The Journal, Nov. 12, 1932, p. 1690; Reports Council Pharm. & Chem., 1932, p. 57. Lutein (Hynson, Westcott & Dunning), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Lutein, Sterile Solution of (Hynson, Westcott & Dunning), The Jour- nal, Jan. 30, 1932, p. 402; Reports Council Pharm. & Chem., 1932, p. 55. Luvein' Arsans (Plain) (Lucas Laboratories, Inc.), The Journal, Sept. 20, 1919, p. 927; Propaganda, vol. 2, p. 440. Luvein' Arsans, Nos. 1, 2 and 3 (Lucas Laboratories, Inc.), The Jour- nal, Sept. 20, 1919, p. 927; Propaganda, vol. 2, p. 441. Luvein' Creosophite (Lucas Laboratories, Inc.), The Journal, Sept. 20, 1919, p. 927; Propaganda, vol. 2, p. 441. Luvein' Hexacol (Lucas Laboratories, Inc.), The Journal, Sept. 20, 1919, p. 927; Propaganda, vol. 2, p. 441. Lycetol (The Bayer Co., Inc.), Reports Council Pharm. & Chem., 1918, p. 70; Propaganda, vol. 2, p. 214. Lydin (Harrower Laboratories, Inc.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 45. Lymph Compound, R-H (New Animal Therapy Co.), The Journal, Dec. 14, 1912, p. 2176; Propaganda, vol. 1, p. 317. Lymphatic Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Lysoform (Lysoform Gesellschaft), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 126. Lysoform, Crude (Lysoform Gesellschaft), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 126. Lysol (Lehn & Fink), The Journal, Dec. 14, 1912, p. 2173, March 21, 1928, p. 1064; Reports Council Pharm. & Chem., 1912, p. 53; Propa- ganda, vol. 1, p. 318. Magnesia-Mineral Oil (25)-Haley (Haley M-0 Co., Inc.), The Journal, April 5, 1930, p. 1067; Reports Council Pharm. & Chem., 1930, p. 34. Maizavena (Wm. S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1912. p. 44. Maizo-Lithium (Henry Pharmacal Co.), The Journal, Feb. 6, 1915, p. 528; Reports Council Pharm. & Chem., 1915, p. 9; Reports Chem. Lab., 1914, p. 65; Propaganda, vol. 1, p. 198. xxxvi BIBLIOGRAPHICAL INDEX Mallophene (Mallinckrodt Chemical Works), The Journal, Dec. 28, 1929, p. 2044. Malnutrition Sero (California Endocrine Foundation Laboratories), The Journal, July 5, 1924, p. 58. Malt Extract with Alteratives, Borcherdt's (Borcherdt Malt Extract Co.), Reports Council Pharm. & Chem., 1918, p. 51. Malt Extract with Calcium, Loeflund's (See Loeflund's Malt Extract with Calcium). Malt Extract with Pepsin and Pancreatin (Wm. S. Merrell Chemical Co.), The Journal, Feb. 9, 1907, p. 533. Malt Extract with Yerba Santa, Borcherdt's (Borcherdt Malt Extract Co.), Reports Council Pharm. & Chem., 1917, p. 138. Malto-Yerbine (Maltine Co.), Reports Council Pharm. & Chem., 1931, p. 62. Maltine with Cascara Sagrada (Maltine Co.), Reports Council Pharm. & Chem., 1931, p. 62. Maltine with Creosote (Maltine Co.), Reports Council Pharm. & Chem., 1931, p. 62. Maltine Ferrated (Maltine Co.), Reports Council Pharm. & Chem., 1931, p. 62. Malt Nutrine (Anheuser Busch, Inc.), The Journal, Dec. 25, 1926, p. 2177; Reports Council Pharm. & Chem., 1926, p. 34. Malt Peptonates with Arsenic, Borcherdt's (Borcherdt Malt Extract Co.), Reports Council Pharm. & Chem., 1917, p. 138. Maltzyme (Maltzyme Company), Reports Council Pharm. & Chem., 1918, p. 67; Propaganda, vol. 2, p. 211. Maltzyme Ferrated (Maltzyme Company), Reports Council Pharm. & Chem., 1918, p. 67; Propaganda, vol. 2. 211. Maltzyme with Cascara Sagrada (Maltzyme Company), Reports Council Pharm. & Chem., 1918, p. 67; Propaganda, vol. 2, p. 211. Maltzyme with Cod Liver Oil (Maltzyme Company), Reports Council Phram. & Chem., 1918, p. 67; Propaganda, vol. 2, p. 211. Maltzyme with Yerba Santa (Maltzyme Company), Reports Council Pharm. & Chem., 1918, p. 67; Propaganda, vol. 2, p. 211. Mammagen (G. W. Carnrick Co.), Reports Council Pharm. & Chem., 1925, p. 20. Mammary Gland, Reports Council Pharm. & Chem., 1921, p. 44. Mammary Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Mammary Substance Desiccated (The Wilson Laboratories), Reports Council Pharm. & Chem., 1923, p. 52. Manaca, Reports Council Pharm. & (Them., 1912, p. 43. Manaca and Salicylates Compound, Elixir (Hance Bros. & White), Reports Council Pharm. & Chem., 1912, p. 44. Manaca and Salicylates Compound, Elixir (Sharp & Dohme), Reports Council Pharm. & Chem., 1912, p. 44. Manaca and Salicylates, Elixir (Wm. S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 44. Manaca and Salicylates, Elixir (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912, p. 44. Manaca with Salicylates, Elixir (Nelson, Baker & Co.), Reports Council Pharm. & Chem., 1912, p. 44. Manaca and Salicylates, Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 44. Manaca and Salicylates, Elixir (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 44. Manaca and Salicylates, Elixir (Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912, p. 44. Manaca and Salicylates, Elixir (F. Stearns & Co.), Reports Council Pharm. & Chem., 1912. p. 44. Manaca and Salicylates, Elixir (Truax, Greene & Co.), Reports Council Pharm. & Chem., 1912, p. 44. Manacaline (Pullen-Richardson Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 44. Manola (Manola Co.), The Journal, April 2, 1910, p. 1154; Reports Chem. Lab., 1910, p. 105; Propaganda, vol. 1, p. 323. Marienbad Tablets (J. Sicke), The Journal, July 18, 1908, p. 237. BIBLIOGRAPHICAL INDEX xxxvii McKesson's Copper-Iron Compound (McKesson & Robbins, Inc.), The Journal, Dec. 26, 1931, p. 1967; Reports Council Pharm. & Chem., 1931, p. 63. McKesson's Vitamin Concentrate of Cod Liver Oil (McKesson & Robbins, Inc.), The Journal, April 27, 1935, p. 1503; Reports Pharm. & Chem., 1935, p. 90. Meat Extract, "Rex" Brand (Cudahy Packing Co.), The Journal, Jan. 23. 1909, p. 311; Propaganda, vol. 1, p. 472. Meat Juice, Valentine's (Valentine's Meat Juice Co.), The Journal, Nov. 20, 1909, p. 1754; May 2, 1914, p. 1419; Reports Council Pharm. & Chem., 1909, p. 137; 1914, p. 14; Propaganda, vol. 1, pp. 123, 129, 472. Medeol Suppositories (Medeol Company, Inc.), The Journal, March 9, 1918, p. 719; Reports Council Pharm. & Chem., 1918, p. 7; Propa- ganda, vol. 2, p. 181. Medicago Abrus Compound (M. L. Howe), The Journal, Feb. 19, 1927, p. 588. Medicago Sativa (M. L. Howe), The Journal, Feb. 19, 1927, p. 588. Medicated Corn Plasters, The Journal, June 18, 1932, p. 2209; Reports Council Pharm. & Chem., 1932, p. 58. Medinal (Schering and Glatz), The Journal, Sept. 6. 1919, p. 755; Nov. 15, 1919, p. 1543; Reports Council Pharm. & Chem., 1919, p. 46; Propaganda, vol. 2, pp. 239, 371. Med-0-Lin (Waverly Oil Works Co.), The Journal, July 10, 1915, p. 175; Reports Council Pharm. & Chem., 1915, p. 172. Meningo-Bacterin-Mulford (H. K. Mulford Co.), Report Council Pharm. & Chem., 1927, p. 42. Meningococcus Serum "Hoechst" (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Meningococcus Vaccine, Reports Council Pharm. & Chem., 1927, p. 42. Meningococcus Vaccine (Lederle) (Lederle Antitoxin Laboratories), Reports Council Pharm. & Chem., 1927, p. 42. Merc-Absorbs (Bio-Chemic Laboratories), The Journal, Feb. 25, 1922, p. 603. Mercodel (Seydel Chemical Co.), The Journal, May 23, 1925, p. 1373; Reports Council Pharm. & Chem., 1925, p. 35. Mercol, Howell's (H. B. Howell & Co., Ltd.), The Journal, Jan. 16, 1909, p. 225; May 15, 1909, p. 1595; Propaganda, vol. 1, p. Z26. Mercurostik (J. Headly Laboratories), Reports Council Pharm. & Chem., 1932, p. 59. Mercurosticks (Tappan Zee Surgical Co.), The Journal, May 19, 1934, p. 1681; Reports Council Pharm. & Chem., 1933, p. 123; 1934, p. 74. Mercury Salicylate-S. D. C, Compressible Capsules, 1 grain, IJ^ grains, 2 grains, for Intramuscular Injection (Synthetic Drug C)o.), Reports Council Pharm. & Chem., 1933, p. 42. Mercury Sozoiodolate, The Journal, Feb. 13, 1909, p. 573; Reports Chem. Lab., 1909, p. 19. Mercury Sozoiodolate Solution, The Journal, Feb. 13, 1909, p. 573; Reports Chem. Lab., 1909, p. 19. Mergel (Riedel & Co., Inc.), Reports Council Pharm. & Chem., 1930, p. 48. Mervenol (Hille Laboratories), Reports Council Pharm. & Chem., 1919, p. 82; Propaganda, vol. 2, p. 249. Metamel (The Newton Laboratories), The Journal, April 5, 1924, p. 1139. Metapollen (Metapollen Lab's), The Journal, Feb. 18, 1933, p. 498; Reports Council Pharm. & Chem., 1933, p. 124. Metatone (Parke, Davis & Co.), The Journal, May 3, 1930, p. 1405; Reports Council Pharm. & Chem., 1930, p. 48. Methaform (F. Stearns & Co.), Reports Council Pharm. & Chem., 1918, p. 68; Propaganda, vol. 2, p. 212. Methylarsenated Tricalcine (Laboratoire des "Produits Scientia"), The Journal, March 14, 1925, p. 836; Reports Council Pharm. & Chem., 1295, p. 80. Methylene Blue, The Journal, May 6, 1933, p. 1402. Methylene Blue, The Journal, Aug. 31, 1935, p. 721. xxxviii BIBLIOGRAPHICAL INDEX Methyl-Phenol Serum (Cano) (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1919, p. 85; Propaganda, vol. 2, p. 251. Methyl-Santal (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1915, p. 173. Micajah's Suppositories (Micajah & Co.), The Journal, Nov. 29, 1919, p. 1715; Reports Council Pharm. & Chem., 1919, p. 49; Propaganda, vol. 2, p. 241. Micajah's Wafers (Micajah & Co.), The Journal, Nov. 29, 1919, p. 1715; Reports Council Pharm. & Chem., 1919. p. 49; Reports Chem. Lab., 1919, p. 55; Propaganda, vol. 2, p. 241. Micrococcus Catarrhalis-Combined-Bacterin, (The Abbott Laboratories), The Journal, June 22, 1918, p. 1967; Reports Council Pharm. & Chem., 1918, p. 11; Propaganda, vol. 2, p. 184. Micrococcus Neoformans Vaccine, Reports Council Pharm. & Chem., 1917, p. 152. Migrainin (Farbwerke-Hoechst Co.), The Journal, June 5, 1909, p. 1851; Reports Council Pharm. & Chem., 1909, p. 105; Propaganda, vol. 1. p. 135. Mineral Water, La Mercy, The Journal, June 22, 1933, p. 280; Reports •Council Pharm. & Chem., 1933, p. 119. "Mineralogen" (Von Bremen-Asche-de Bruyn). The Journal, Sept. 19, 1931, p. 852; Reports Council Pharm. & Chem., 1931, p. 69. Mineral "Ox" (Mineral Oxide Co.), Reports Council Pharm. & Chem., 1934, p. 69. Minson's Soluble lodin "Kelpidine" (J. J. Minson), Reports Council Pharm. & Chem., 1917, p. 152; Propaganda, vol. 2, p. 161. Mist. Helonin Comp. (Schlotterbeck & Foss), The Journal, Dec. 18, 1915, p. 2186. Mistura Creosote Comp. (Killgore's) (Chas. Killgore), The Journal, March 8, 1924, p. 812; Reports Council Pharm. & Chem., 1924, p. 46. Mitchella Compound (Dr. J. H. Dye Medical Institute), Reports Council Pharm. & Chem., 1912, p. 46. Mitysol (Lehn & Fink, Inc.), The Journal, March 21, 1925, p. 914; Reports Council Pharm. & Chem., 1925, p. 64. Mixed Staphylococcus Acne Vaccine, The Journal, Jan. 23, 1926, p. 294; Reports Council Pharm. & Chem., 1925, p. 70. Mixed Vaccines. — See Vaccines, Mixed. Mixed Vaccine No. 40, Sherman's (G. H. Sherman), The Journal, June 22, 1918. p. 1967; Reports Council Pharm. & Chem., 1918, p. 11; Propaganda, vol. 2, p. 188. Modilac (Wm. S. Merrell Co.), The Journal, March 8, 1930. p. 716; Reports Council Pharm. & Chem.. 1930, p. 51. Mon-Arsone (The Harmer Laboratories Co.), The Journal, Feb. 26, 1921, p. 595; June 18, 1921. p. 1781; Reports Chem. Lab., 1920, p. 67; Reports (Council Pharm. & Chem., 1921, p. 47; Propaganda, vol. 2, pp. 302, 492. Mono-iodo-cinchophen (see Farastan), (Farastan Co.), The Journal, April 18, 1936, p. 1473. Morphine Meconate, Reports Council Pharm. & Chem., 1919, p. 84. Mother's Cordial (Eli Lilly & Co.), The Journal, Aug. 31, 1912, p. 735; Reports Council Pharm. & Chem., 1912, p. 46; Propaganda, vol. 1, p. 410. Mother's Cordial (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 46. Motherwort, Reports Council Pharm. & Chem., 1912, p. 44. Mucol Powder (Mucol Co., Inc.), The Journal, Nov. 15, 1913, p. 1812; Reports Council Pharm. & Chem., 1913, p. 43; Propaganda, vol. 1, p. 329. Mulene (Mulene Co.), The Journal, May 19, 1917, p. 1497; Propa- ganda, vol. 2, p. 332. Murasenide (Miller Biological Laboratories), The Journal, July 31, 1926, p. 343; Reports Council Pharm. & Chem.^ 1926, p. 35. Muthol (Demuth's Laboratories), The Journal, July 10, 1915, p. 175. Mylin (Mifflin Chemical Corp.), Reports Council Pharm. & Chem., 1930, p. 52; The Journal, Jan. 10, 1931, p. 64. Myodine (I-O-Dine Laboratories), The Journal, Feb. 20, 1932, p. 639; Reports Council Pharm. & Chem., 1932, p. 60. BIBLIOGRAPHICAL INDEX xxxix Naftalan (Ft. Dearborn Drug & Chemical Co.), The Journal, Aug. 14, 1926, p. 509; Reports Council Pharm. & Chem., 1926, p. 36. Naiodine (E. Fougera & Co.), The Journal, June 24, 1933, p. 2008; Reports Council Pharm. & Chem., 1933, p. 127. Naphey's Medicated Uterine Wafers, Reports Council Pharm. & Chem., 1916, p. 66. Narcosan (Horovitz) (Biochemical Laboratories), The Journal, Dec. 18, 1926, p. 2097; Jan. 21, 1929, p. 151. Narkine (The Tilden Co.), The Journal, Oct. 24, 1908, p. 1439; Propa- ganda, vol. 1, p. 329. National Iodine Solution (National Drug Co.), The Journal, June 4, 1921, p. 1592; Reports Council Pharm. & Chem., 1921, p. 50; Propaganda, vol. 2, p. 300. National Radium Emanator (National Radium Products Co.), The Jour- nal, April 6, 1929, p. 1181; Reports Council Pharm. & Chem., 1929, p. 36. Natrium Compound, Pulvoids. — See Pulvoids Natrium Compound. Nauseatin I (Krause Medico Gesellschaft). The Journal, Oct. 31, 1931, p. 1300; Reports Council Pharm. & Chem., 1931, p. 64. Nauseatin II (Krause Medico Gesellschaft), The Journal, Oct. 31, 1931, p. 1300; Reports Council Pharm. & Chem., 1931, p. 64. Nazol (Nazol Antiseptic Co.), Reports Council Pharm. & Chem., 1918, p. 81. Neisser (Gonococcic) Vaccine (National Drug Co.), The Journal, Jan. 5, 1929, p. 55; Reports Council Pharm, & Chem., 1928, p. 43. Neisser Serobacterin Mixed (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1916, p. 67. Neisser-San-Kahn (York Laboratories Company, Inc.), The Journal, Jan. 20, 1923, p. 201; Reports Council Pharm. & Chem., 1923, p. 53. Nelson Elixir Ovarans (American Laboratories, Inc.), The Journal, May 1, 1926, p. 1383; Reports Council Pharm. & Chem., 1926, p. 55. Neobovinine 20 (Bovinine Co.). The Journal, March 7, 1931, p. 860; Reports Council Pharm. & Chem., 1931, p. 36. Neocaine (Anglo-French Drug Co.), The Journal, Jan. 21, 1933, p. 210. Neocinchophen-B. P. C. (Benzol Products Co.), Reports Council Pharm. & Chem., 1933, p. 31. Neo-Merphenol (Lynch & Co.), The Journal, Aug. 31, 1935, p. 738. Neo-Reargon (C. P. Chemical and Drug Co.), The Journal, Oct. 23, 1926, p. 140; Reports Council Pharm. & Chem., p. 38. Neo-Riodine (P. Astier Laboratories), Reports Council Pharm. & Chem., 1924, p. 47. Neotrepol (Anglo-French Drug Co.), The Journal, Jan. 9, 1925, p. 136; Reports Council Pharm. & Chem., 1925, p. 75. Nephritin (Reed & Carnrick Co.), The Journal, Oct. 5, 1907, p. 1198; April 21, 1923, p. 1167; Reports Council Pharm. & Chem., 1905-8, p. 79. Nephro Sero (California Endocrine Foundation Laboratories), The Jour- nal, July 5, 1924, p. 58. Nephroson (Wm. S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 39. Nerve Vitalizer, Wheeler's (J. W. Brant Co., Ltd.), The Journal, April 11. 1908, p. 1206; Reports Chem. Lab., to 1909, p. 66; Propa- ganda, vol. 1, p. 411. Neubone, The Journal, Feb. 9, 1924, p. 489. Neurilla (Dad Chemical Co.), The Journal, March 27, 1915, p. 1093; Reports Council Pharm. & Chem., 1915, p. 20; Propaganda, vol. 1, p. 136. Neurocaine (Schieffelin & Co.), Reports Council Pharm. & Chem., 1915, p. 173. Neuro-Lecithin-Abbott (The Abbott Laboratories), Reports Council Pharm. & Chem., 1915, p. 122; Propaganda, vol. 2, p. 53. Neuro Phosphates, Eskay's (Smith, Kline & French Co.). The Journal, Sept. 29, 1917, p. 1102; Reports Council Pharm. & Chem., 1917, p. 52; Propaganda, vol. 2, p. 146. Neurosine (Dios Chemical Co.), The Journal, Jan. 9. 1915, p. 165; April 27, 1918, p. 1251; Reports Council Pharm. & Chem., 1914, p. 86; Propaganda, ed. 9, p. 139; Propaganda, vol. 2, p. 404; The Journal, Oct. 10, 1925, p. 1155. xl BIBLIOGRAPHICAL INDEX Neutrogen St. Pellegrino Antacid Lozenges (Societa Anonimo delle Terme di San Pellegrino), The Journal, Nov. 21, 1931, p. 66; Reports Council Pharm. & Chem., 1931, p. 66. Niazo (Schering Corporation), The Journal, June 3, 1933, p. 1767; Reports Council Pharm. & Chem., 1933, p. 129. Nicomors (Nicomors Products Co.), The Journal, July 19, 1924, p. 212; Reports Council Pharm. & Chem., 1924, p. 48. Ninhydrin, The Journal, March 2, 1929, p. 724. Nitroscleran (E. Tosse & Co., Inc.), The Journal, March 5, 1927, p. 474. Nitronine (American Pharmacal Co.), Reports Council Pharm. & Chem., 1922. p. 50. Noitol (Wheeler Chemical Works), The Journal. May 21, 1910, p. 1704; Reports Chem. Lab., 1910, p. 45; Propaganda, vol. 1, p. 245. Non-Tox (Bradford Chemical Co.), Reports Council Pharm. & Chem., 1926, p. 41. N6rmal Horse Serum, Sterile (National Vaccine and Antitoxin Insti- tute), Reports Council Pharm. & Chem.. 1921, p. 53. Normaline, Hayner's: See Hayner's Normaline. Normal Phenol Serum (Cano) (H. K. Mulford Co.'), Reports Council Pharm. & Chem., 1919, p. 85; Propaganda, vol. 2, p. 251. Norniet Solution: See Solution Normet. Noron (The Heron Company), Reports Council Pharm. & Chem., 1921, p. 53. Nose-Ions (Nose-Ions Company), The Journal, Dec. 4, 1915, p. 2026; Reports Chem. Lab., 1915, p. 123. Nourry Wine (E. Fougera & Co., Inc.), The Journal, Dec. 12, 1914, p. 2150; Reports Council Pharm. & Chem., 1914, p, 74; Reports Chem. Lab., 1921, p. 31; Propaganda, vol. 1, p. 115. . Nuclein, Reports Council Pharm. & Chem., 1921, p. 54. Nucleinic Acid, Reports Council Pharm. & Chem., 1921, p. 54. Nuforal (The Nuforal Laboratories, Inc.), The Journal, Jan. 7, 1922, p. 59. Nujol (Standard Oil Co. of New Jersey), The Journal, July 10, 1915, p. 175; Reports Council Pharm. & Chem., 1916, p. 68; Propaganda, vol. 2, p. 108. Number "3" (Chlorine Products Company, Inc.), Reports Council Pharm. & Chem., 1919, p. 70; Reports Chem. Lab., 1919, p. 57; Propaganda, vol. 2, p. 244. NuTone (NuTone Company), Reports Council Pharm. & Chem., 1917, p. 154; Propaganda, vol. 2, p. 162. Nutrient Wine of Beef Peptone (Armour & Co.), The Journal, May 11, 1907, p. 1612; Reports Council Pharm. & Chem., 1905-8, opp. p. 64; Propaganda, vol. 1, p. 133. Nutritive Liquid Peptone (Parke, Davis & Co.), The Journal, May 11, 1907, p. 1612; Reports Council Pharm. & Chem., 1905-8, opp. p. 64; Propaganda, ed. 9, p. 133. Nutrolactis (The Nutrolactis Co.), The Journal. May 26, 1917, p. 1570; Reports Council Pharm. & Chem., 1917, p. 24; Propaganda, vol. 2, p. 131. Nuxated Iron (Dae Health Laboratories), The Journal, Oct. 21, 1916, p. 1244; Oct. 28, 1916, p. 1309; Nov. 4. 1916, p. 1376; Feb. 24, 1917, p. 642; Reports Chem. Lab., 1916, p. 29. Oats, Reports Council Pharm. & Chem., 1912, p. 44. Octozone (Octozone Corporation of America), Reports Council Pharm. & Chem., 1933, p. 131; The Journal. Feb. 24, 1934, p. 605. Oestroform (British Drug Houses), The Journal, August 31, 1935, p. 667. Oil of Cypress-Schimmel (Fritzsche Bros., Inc.), The Journal, April 7, 1934, p. 1154; Reports Council Pharm. & Chem.. 1934, p. 34. Ointment (Targentos and Ichthyol (H. K. Mulford & Co.), Reports Coun- cil Pharm. & Chem., 1923. p. 10. Ointment Scabicide (Upjohn Co.), The Journal, May 20, 1933, p. 1597; Reports Council Pharm. & Chem., 1933, p. 31. Olajen (Olajen, Inc.). The Journal, Sept. 26, 1931, p. 930; Reports Council Pharm. & Chem., 1931. p. 71. Oleosolution (Nizza Laboratories), The Journal, Dec. 4, 1926, p. 1933; Reports Council Pharm. & Chem., 1926, p. 44. BIBLIOGRAPHICAL INDEX xli Oleothesin (Oleothesin Co.), The Journal, March 31, 1934, p. 1003; Reports Council Pharm. & Chem., 1934, p. 72. Olio-Phlogosis (Mystic Chemical Company), The Journal, Aug. 19, 1916, p. 631; Reports Council Pharm. & Chem., 1916, p. 10; Propaganda, vol. 2, p. 79. Omnadin (H. A. Metz Laboratories, Inc.), The Journal, April 15, 1933, p. 1172; Reports Council Pharm. & Chem., 1933, p. 133. Onolin (Southwest Medical Supply Co.), The Journal, Dec. 20, 1930, p. 1933. Ophthalmol-Lindermann (Innis, Speiden & Co.), The Journal, July 6, 1918, p. 59; Reports Council Pharm. & Chem., 1918, p. 21; Propa- ganda, vol. 2. p. 189. Optochin Base (Merck & Co.), Reports Council Pharm. & Chem., 1933, p. 136. Optolactin (Fairchild Bros. & Foster), The Journal, Jan. 13, 1923, p. 127; Reports Council Pharm. & Chem., 1922, p. 27. Orargol (Anglo-French Drug Co.), The Journal, Oct. 17, 1925, p. 1241; Reports Council Pharm. & (^hem., 1925, p. 58. Orchic Extract (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Orchic Solution (Rovin) (A. M. Rovin Lab's),' The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Orchitic Fluid Tablets (New Animal Therapy Co.), The Journal, Dec. 14, 1912, p. 2176; Propaganda, vol. 1, p. 317. Orchitic Substance-Cousineau (See Concentrated Orchitic Solution). Organic Luetin (Abbott Laboratories), The Journal, Sept. 16, 1933, p. 929; Reports Council Pharm. & Chem., 1933, p. 137. Organ-0-Tones No. 19 (Cole Chemical Co.), The Journal, Dec. 25, 1926, p. 2178. Orsudan (Burroughs Wellcome & Co.), The Journal, April 16, 1910, p. 1323. Oro Brand Kelp Salt (Oakland Food Products Co.), The Journal, Feb. 20, 1932, p. 640; Reports Council Pharm. & Chem., 1932, p. 96. Osmium Tetroxide, Reports (ilouncil Pharm. & Chem., 1921, p. 55. Osmogen (Lipoidal Laboratories, Inc.), The Journal, Oct. 13, 1928, p. 1129; Dec. 21, 1929, p. 1974. Otosclerol Tablets (Muenchner Pharmazeutische Fabrik), The Journal, Sept. 14, 1929, p. 867. Ovacoids (Reed & Carnrick), The Journal, Feb. 5, 1927, p. 422. Ovarian Preparations, Injectable, The Journal, Jan. 30, 1932, p. 402; Reports Council Pharm. & Chem., 1932, p. 55. Ovarian Residue Desiccated-P. D. & Co. (Parke, Davis & Co.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Ovarian Residue-H. W. & D. (Hynson, Westcott & Dunning), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Ovarian Residuc-Lederle (Lederle Laboratories, Inc.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Ovarian Residue-P.-M. Co., Desiccated (Pitman-Moore Co.), The Jour- nal, June 24, 1930, p. 1997. Ovarian Residue Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Ovarian Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Ovarian Residue-Wilson (Wilson Laboratories), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Ovarian Substance-Armour (Armour & Co.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Ovarian Substance (G. W. Carnrick Co.), Reports Council Pharm. & Chem., 1922, p. 52. Ovarian Substance Desiccated (Parke, Davis & Co.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Ovarian Substance Soluble Extract-P. D. & Co. (Parke, Davis & Co.), The Journal, Jan. 30, 1932, p. 402; Reports Council Pharm. & Chem., 1932, p. 55. xlii BIBLIOGRAPHICAL INDEX Ovarian Substance-P.-M. Co., Desiccated (Pitman-Moore Co.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Ovarian Substance-Wilson (Wilson Laboratories), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Ovary, Whole-H. W. & D. (Hynson, Westcott & Dunning). The Jour- nal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Ovary, Whole-Lederle (Lederle Laboratories, Inc.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 25. Ovestrumon (Vitalait Laboratory of California, Ltd.), The Journal, Oct. 24, 1931, p. 1226; Reports Council Pharm. & Chem., 1931, p. 73. Ovoferrin (A. C. Barnes Co.), The Journal, May 4, 1929, p. 156; Reports Council Pharm. & Chem., 1929, p. 2>7 . Oxoate (Smith, Kline & French Co.), The Journal, June 30, 1928, p. 2103; Reports Council Pharm. & Chem., 1928, p. 40. Oxoate "B" (Smith, Kline & French Co.), The Journal, June 30, 1928, p. 2103; Reports Council Pharm. & Chem., 1928, p. 40. Oxone (R. & H.), The Journal, April 22, 1933, p. 1237; Reports Council Pharm. & Chem., 1933. p. 29. Oxycatalyst, Armstrong's (Radium Research Foundation), The Journal, May 19, 1928, p. 1647. Oxychlorine (Oxychlorine Co.), The Journal, July 6, 1907, p. 54; Reports Council Pharm. & Chem., 1905-1908, p. 68; Reports Chem. Lab., 1921, p. 52; Propaganda, vol. 1, p. 147. Oxydendron Compound, Fluidextract (Nelson, Baker & Co.), Reports Council Pharm. & Chem., 1912, p. 43. Oxylin (Evons Laboratories), The Journal. Sept. 23, 1933, p. 1020. Oxyl-Iodide (Eli Lilly & Co.), The Journal, July 2, 1921, p. 57; Reports Council Pharm. & Chem., 1921, p. 56; Propaganda, vol. 2, p. 304. Oxyntin (Fairchild Bros. & Foster), Reports Council Pharm. & Chem., 1915, p. 174. P. & S. Bowel Evacuant (N. C. Goodwin Laboratory, Inc.), Reports Council Pharm. & Chem., 1927, p. 42. Pabst Extract (Pabst Corporation), The Journal, Nov. 20, 1926; p. 1760; Reports Council Pharm. & Chem., 1926, p. 46. Painodynes (Wm. A. Webster Co.), The Journal, May 17, 1924, p. 1632; Nov. 22, 1924, p. 1705. Palmetto Compound (Wm. S. Merrell Chem. Co.), Reports Council Pharm. & Chem.. 1912, p. 44. Palpebrine (Dios (Chemical Co.), The Journal, Jan. 9, 1915, p. 167; Reports Council Pharm. & (Ihem., 1914, p. 86; Propaganda, vol. 1, p. 139. Pal's Gum Balsam No. 2 (Bushwick Pharmacy), Reports Council Pharm. & Chem., 1930, p. 53. Pam-ala (Pam-Ala Co.), The Journal, Feb. 28, 1914, p. 715; Propa- ganda, vol. 1, p. 149. Panase (Frederick Stearns & Co.), The Journal, June 14, 1930, p. 1919; Reports Council Pharm. & Chem.. 1930, p. 28. Pancreas Co. (Harrower Laboratory, Inc.), The Journal, Oct. 16, 1926, p. 1322. Pancreols (Drug Products), The Journal, July 16. 1927, p. 229. Pancreopepsin, Liquid (Wm. R. Warner & Co.), The Journal, Feb. 9, 1907, p. 533. Pancrepatine (Anglo-French Drug Co.), The Journal, March 3, 1928, p. 714. Pancresal Tablets (Pancresal Sales Co.), The Journal, May 27, 1933, p. 1686; Reports Council Pharm. & Chem.. 1933, p. 140. Panopepton (Fairchild Bros. & Foster), Reports Council Pharm. & Chem., 1922, p. 48. Pan-peptic Elixir (Sharp & Dohme), The Journal, Feb. 9, 1907, p. 533. Pan-secretin (The Harrower Laboratory), The Journal, March 10, 1923, p. 717; Oct. 16, 1926, p. 1322. Pantopon-Roche (Hoffmann-LaRoche, Inc.), The Journal, Oct. 3, 1931, p. 1001; Reports Council Pharm. & Chem., 1931, p. 75. Papain, The Journal, Feb. 9, 1907, p. 522. BIBLIOGRAPHICAL INDEX xliii Pa-pay-ans, Bell (Bell & Co.), (See Bell-ans). Papine (Battle & Co.), The Journal, April 29, 1911, p. 1278; Reports Chem. Lab., 1911, p. 82; Propaganda, ed. 9, p. 330. Para Coto, Reports Council Pharm. & Chem., 1913, p. 39. Paracotoin, Reports Council Pharm. & Chem., 1913, p. 39. Paraffin for Films, Reports Council Pharm. & Chem., 1933, p. 142. Paraganglina Vassale (Neother Products Co.), The Journal, June 21, 1924, p. 2068; Reports Council Pharm. & Chem., 1924, p. 11. Parathesin (H. A. Metz Laboratories, Inc.), The Journal, Nov. 13, 1920, p. 1358; Reports Council Pharm. & Chem., 1920, p. 27; Propa- ganda, vol. 2, p. 276. Parathyroid Gland Desiccated-P. D. & Co. (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1927, p. 24. Pariogen Tablets (American Drug & Chemical Co.), The Journal, Feb. 7, 1931, p. 458. Pasadyne (John B. Daniel), The Journal, March 8, 1913, p. 766; Propa- ganda, vol. 1, p. 332. Pas-Avena (Pas-Avena Chemical Company), The Journal, March 7, 1908. p. 783; Reports Chem. Lab., to 1909, p. 69; Propaganda, vol. 1, p. 333. Pascarnata (Wm. S. Merrell Co.), The Journal, Dec. 15, 1928, p. 1914. Pasconia (William S. Merrell Co.), The Journal, July 16, 1927, p. 229. Pasiflora, The Journal, March 19, 1910, p. 983; Reports Council Pharm. & Chem., 1912, p. 38; Propaganda, vol. 1, p. 156. Pasiflora Incarnata, Daniel's Concentrated Tincture of (John B. Daniel), The Journal, March 19, 1910, p. 983; Reports Council Pharm. & Chem., 1910, p. 44; 1912, p. 38; Propaganda, vol. 1, p. 156. Pautauberge's Solution (Geo. J. Wallau, Inc.), The Journal, March 7, 1910, p. 1560. Pepsin and Pancreatin Compound, Elixir (Eli Lilly & Co.), The Jour- nal, Feb. 6, 1907, p. 533. Pepsin and Pancreatin Compound, Tablets (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 40. Pepsin and Pancreatin, Elixir (Eli Lilly & Co.), The Journal, Feb. 9, 1907, p. 533. Pepsin and Pancreatin, Elixir (Sharp & Dohme), The Journal, Feb. 9, 1907, p. 533. Pepsin and Pancreatin, Elixir (Smith, Kline & French Co.), The Jour- nal, Feb. 9, 1907, p. 533. Pepsin and Pancreatin, Elixir (F. Stearns & Co.), The Journal, Feb. 9, 1907, p. 533. Pepsin and Pancreatin, Elixir (Wra. R. Warner & Co.), The Journal, Feb. 9. 1907, p. 533. Pepsin and Pancreatin with Caffein, Elixir (Eli Lilly & Co.), The Journal, Feb. 9, 1907, p. 533. Pepsin, Bismuth and Pancreatin, Elixir (Sharp & Dohme), The Journal, Feb. 9, 1907, p. 533. Pepsin, Bismuth and Pancreatin, Elixir (Smith, Kline & French Co.), The Journal, Feb. 9, 1907, p. 533. Pepsin, Bismuth and Pancreatin, Elixir (F. Stearns & Co.), The Jour- nal, Feb. 9, 1907, p. 533. Pepsin, Elixir Lactated (H. K. Mulford Co.), The Journal, Feb. 9, 1907, p. 533. Pepsin, Elixir Lactated (Parke, Davis & Co.), The Journal, Feb. 9, 1907, p. 533. Pepsin, Elixir Lactinated (F. Stearns & Co.), The Journal, Feb. 9, 1907, p. 533. Pepsin, Pancreatin and Bismuth, Elixir (Eli Lilly & Co.), The Journal, Feb. 9, 1907, p. 533. Pepsin, Pancreatin, Bismuth and Strychnin, Elixir (Eli Lilly & Co.), The Journal, Feb. 9, 1907, p. 533. Pepsin, Strychnin, Bismuth and Pancreatin, Elixir (Sharp & Dohme), The Journal, Feb. 9, 1907, p. 533. Peptenzyme, Elixir (Reed & Carnrick Co.), The Journal, Feb. 9, 1907, p. 533; Oct. 5, 1907, p. 1198; Reports Council Pharm. & Chem., 1905-8, p. 79. Peptenzyme Powder (Reed & Carnrick Co.), The Journal, Oct. 5, 1907, p. 1198; Reports Council Pharm. & Chem., 1905-8, p. 79. xliv BIBLIOGRAPHICAL INDEX Peptic Digestant (Columbus Pharmacal Co.), The Journal, Feb. 9, 1907, p. 533. Peptic Essence Comp., Peters' (Arthur Peters & Co.), The Journal, Feb. 9, 1907, p. 533. Pepto-Mangan (M. J. Breitenbach Co.). The Journal, Sept. 23, 1905, p. 934: April 6, 1907, p. 1197; Dec. 29, 1917, p. 2202; Reports Council Pharm. & Chem., 1914, p. 121; Propaganda, vol. 1, p. 159; Propaganda, vol. 2, p. 387. Peptone, Reports Council Pharm. & Chem., 1913, p. 41. Peptone Solution for Hypodermatic Use (Armour) (Armour & Co.), The Journal, Nov. 29, 1924, p. 1786; Reports Council Pharm. & Chem., 1924, p. 50. Peptonic Elixir (Wm. S. Merrell Chemical Co.), The Journal, May 11, 1907, p. 1612; Reports Council Pharm. & Chem., 1905-8, opp. p. 64; Propaganda, vol. 1, p. 133. Peptoprotcasi (Neother Products Co.), The Journal, June 21, 1924, p. 2068; Reports Council Pharm. & Chem., 1924, p. 11. Pepto-Salicylas Compound (Curtis Pharmacal Co.), The Journal, May 28, 1932, p. 1884; Reports Council Pharm. & Chem., 1932, p. 65. Peralga (Schering & Glatz), The Journal, March 31, 1923, p. 942; Oct. 23, 1926, p. 1412; Reports Chem. Lab., 1923, p. 58. Perfection Liquid Food (Perfection Liquid Food Co.), Reports Council Pharm. & Chem., 1913, p. 44; Reports Chem. Lab., 1913, p. 80. Pernocton (Riedel-de Haen), The Journal, Oct. 3, 1931, p. 1001; Reports Council Pharm. & Chem., 1931, p. 77. Pernoston (formerly Pernocton) (Riedel-de Haen, Inc.), Reports Council Pharm. & Chem., 1934, p. 74. Perogen Bath (Morgenstern & Co.), Reports Council Pharm. & Chem., 1931, p. 37. Pertussin (Lehn & Fink), The Journal, March 8, 1913, p. 766; The Journal, March 27, 1920, p. 905; Propaganda, vol. 1, p. 334; Propa- ganda, vol. 2, p. 467. Pertussin (Seeck and Kade), The Journal, Feb. 20, 1926, p. 573. Pertussis Bacterin Mixed (H. K. Mulford (^o.). Reports Council Pharm. & Chem., 1923, p. 56. Pertussis Bacillus Vaccine (Gilliland Laboratories, Inc.), The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Pertussis Bacillus Vaccine (Hollister-Stier Laboratories), The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Pertussis Bacterin (H. K. Mulford Co.), The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Pertussis Bacterin Prophylactic (Swan-Myers & Co.), The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Pertussis-Combined-Bacterin (The Abbott Laboratories), The Journal, June 22, 1918, p. 1967; Reports Council Pharm. & Chem., 1918, p. 11; Propaganda, vol. 2, p. 185. Pertussis Glycerol-Vaccine (Lederle Laboratories, Inc.), The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem.. 1930, p. 54. Pertussis Immunogen (Parke, Davis & Co.), The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Pertussis Immunogen Combined (Parke, Davis & Co.), The Journal, Sept. 17, 1927, p. 984; Reports Council Pharm. & Chem., 1927, p. 37. Pertussis Serobacterin Mixed (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1923^ p. 56. Pertussis Vaccine Curative (E. R. Squibb & Sons), The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Pertussis Vaccine for Prophylaxis (Lederle Laboratories, Inc.). The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Pertussis Vaccine for Treatment (Lederle Laboratories, Inc.), The Jour- nal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Pertussis Vaccine (Eli Lilly & Co.), The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Pertussis Vaccine Immunizing (E. R. Squibb & Sons), The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Pertussis Vaccine (National Drug Co.), The Journal, Feb.' 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. BIBLIOGRAPHICAL INDEX xlv Pertussis Vaccine (Parke, Davis & Co.), The Journal, Feb. 21, 1931, p. 613: Reports Council Pharm, & Chem., 1930, p. 54. Pertussis Vaccine, Immunizing (Sauer) (U. D. & Co), Reports Council Pharm. & Chem.. 1935, p. 92. Petrolagar (Alkaline) (Deshell Laboratories, Inc.), Reports Council Pharm. & Chem.. 1927, p. 43. Phagoid-Bacillus Colon (The Phagoid Lab's, Inc.), The Journal, March 14, 1936, p. 922; Reports Council Pharm. & Chem., 1936, p. ^^3. Phagoid-Staphylococcus (The Phagoid Lab's, Inc.), The Journal, March 14, 1936, p. 922; Reports Council Pharm. & Chem., 1936, p. 63. Phagoid-Streptococcus Hemolyticus (The Phagoid Lab's, Inc.), The Journal, March 14, 1936, p. 922; Reports Council Pharm. & Chem., 1936, D. 63. Phecolates '(F. Waldo Whitney), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 127; Propaganda, vol. 1, p. 174. Phecolax (F. Waldo Whitney), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 127; Propaganda, vol. 1, p. 174. Phecotones (F. Waldo Whitney), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 127; Propaganda, vol. 1, p. 174. Phecozymes (F. Waldo Whitney), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914; p. 127; Propaganda, vol. 1, p. 174. Phenalein (Pax Chemical Co.), The Journal, April 30, 1910, p. 1458; Propaganda, vol. 1, p. 344. Phenalgin (Etna Chemical Co.), The Journal, June 3, 1905, p. 1791; Jan. 27, 1912, p. 293; Feb. 8, 1918, p. 337; Reports Council Pharm. & Chem., 1905-8, p. 8; Propaganda, vol. 1, pp. 10, 335; Propaganda, vol. 2, p. 393. Pheno-Bromate (Pheno-Bromate Co.), The Journal, July 14, 1906, p. 125; April 18, 1908, p. 1282; Propaganda, vol. 1, p. 343. Pheno-Isolin (Scientific Mfg. Co.), The Journal, May 30, 1931, p. 1978. Phenolax Wafers (Upjohn Co.), The Journal, April 30, 1910, p. 1458; Propaganda, vol. 1, p. 344. Phenoseptine Cones (Mertes Remedy Co.), The Journal, July 31, 1926, p. 343; Reports Council Pharm. & Chem., 1926, p. 47. Phenoseptine Powder (Mertes Remedy Co.), The Journal, July 31, 1926, p. 343; Reports Council Pharm. & Chem., 1926, p. 47. Phenol Sodique (Hance Bros. & White), The Journal, Nov. 9, 1907, p. 1617; Reports Council Pharm. & Chem., 1905-8, p. 99; Propa- ganda, vol. 1, p. 175. Phenolphthalein Laxative (El Zernac Co.), The Journal, April 30, 1910, p. 1458; Propaganda, vol. 1, p. 344. Phos-Hepatic Extract, Matthew's (Livermeal Corp.), The Journal, March 24, 1928, p. 997. Phos-Phane (Lambert Chemical Co.), The Journal, July 2, 1932, p. 55. Phosphobion (Carl F. Lauber), The Journal, Sept. 3, 1927, p. 809; Reports Council Pharm. & Chem., 1927, p. 43. Phosphoglycerate of Lime (Chapoteaut) (E. Fougera and Co., Inc.). The Journal, Sept. 30, 1916, p. 1034; Reports Council Pharm. & Chem.. 1916, p. 35; Propaganda, vol. 2, p. 95. Phospho-Muriate of Quinine Comp.-Phillips (Charles H. Phillips Chem- ical Co.), The Journal, Oct. 19, 1918, p. 1335; Reports Council Pharm. & Chem., 1918, p. 32; Propaganda, vol. 2, p. 197. Phosphorcin Compound (Organic Products Company), The Journal, Sept. 30, 1916, p. 1033; Reports Council Pharm. & Chem., 1916, p. 34; Propaganda, vol. 2, p. 94. Phosphorus, Amorphous, The Journal, March 7, 1914, p. 793; March 28, 1914, p. 1033; Propaganda, vol. 1, p. 478. Phosphorus, Amorphosus, Pill, S. & D. (Sharp & Dohme), The Journal, March 7, 1914, p. 793; March 28, 1914, p. 1033; Propaganda, vol. 1, p. 478. Phosphorus Tonic Compound, Dowd's (The Richardson Company), The Journal, Dec. 20, 1913, p. 2258; Propaganda, vol. 1, p. 476. xlvi BIBLIOGRAPHICAL INDEX Phospho-Vanadiol (Vanadium Chemical Co.), The Journal, Jan. 18, 1913, p. 225; Reports Council Pharm. & Chem., 1913, p. 7; Propa- ganda, vol. 1, p. 209. Phylacogens (Parke, Davis & Co.), The Journal, Feb. 1, 1913, p. 384; Feb. 22, 1913, pp. 602, 615; March IS, 1913, p. 849; Aug. 29. 1914, p. 785; Nov. 15, 1919, p. 1542; Propaganda, vol. 1, p. 346; Propa- ganda, vol. 2, p. 441. Phyllicin (Bilhuber-Knoll Corp.). The Journal, March 25, 1933, p. 886; Reports Council Pharm. & Chem., 1933, p. 143. Phyllosan (Merck & Co.), Reports Council Pharm. & Chem., 1923, p. 57. Phyone (Wilson Laboratories), The Journal, Aug. 31, 1935, p. 667. Phytin (A. Klipstein & Co.), The Journal, Jan. 30, 1915, p. 456; Reports Council Pharm. & Chem., 1915, p. 131; Propaganda, vol. 1, p. 178. Phytoline (Walker Pharmacal Co.), The Journal, Dec. 20, 1924, p. 2040. Picrotoxin, The Journal, Aug. 1, 1936, p. 354; Reports Council Pharm. & Chem., 1936, p. 88. Pil, Cascara Comp.-Robins (A. H. Robins Co.), The Journal, Jan. 27, 1917, p. 303; Reports Council Pharm. & Chem., 1916, p. 47; Propa- ganda, vol. 2, p. 117. Pil. Mixed Treatment (Chichester) (Hillside Chemical Co.), The Jour- nal, Oct. 22. 1921, p. 1355; Reports Council Pharm. & Chem., 1921. p. 60; Reports Chem. Lab., 1921, p. 40; Propaganda, vol. 2, p. 310. pineal Comp. (Male), Special Formula No. 3 (G. W. Carnrick Co.), The Journal, Feb. 28, 1925, p. 695; Reports Council Pharm. & Chem., 1925, p. 85. Pineal Comp. (Female), Special Formula No. 4 (G. W. Carnrick Co.), The Journal, Feb. 28, 1925, p. 695; Reports Council Pharm. & Chem., 1925, p. 85. Pineal Gland, Reports Council Pharm. & Chem., 1918, p. 69. Pineal Gland-Armour, Desiccated (Armour & Co.), Reports Council Pharm. & Chem., 1918, p. 69; Propaganda, vol. 2, p. 213. Pinnecksin (International Food Products, Inc.), The Journal, Feb. 1, 1930, p. 339; Reports Council Pharm. & Chem.. 1929, p. 37. Pinoleum (The Pinoleum Company). The Journal, Nov. 1, 1919, p. 1380; Propaganda, vol. 2, p. 442. Pinus Canadensis, Kennedy's, Dark. — See Darpin. Pinus Canadensis. Kennedy's Light. — See Abican. Pinuseptol (Eli Lilly & Co.), The Journal, Jan. 28, 1922, p. 299. Piperazine (The Bayer Co., Inc.), Reports Council Pharm. & Chem., 1918, p. 70; Propaganda, vol. 2, p. 214. Piperazine Water (Lehn & Fink), The Journal, Feb. 29, 1908, p. 704. Pituglandol-Roche (Hoffmann-LaRoche, Inc.), The Journal, Aug. 17. 1929, p. 524; Reports Council Pharm. & Chem., 1929, p. 39. Pituitrin "S" (Surgical) (Parke, Davis & Co.), The Journal, Aug. 17, 1929, p. 524; Reports Council Pharm. & Chem., 1929. p. 39. Pituitary Anterior Desiccated (G. W. Carnrick Co.), Reports Council Pharm. & Chem., 1922, p. 52. Pituitary, Anterior Desiccated-Lederle (Lederle Laboratories, Inc.), The Journal, Tune 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Pituitary, Anterior, Desiccated-P.-M. Co. (Pitman-Moore Co.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Pituitary Body, Anterior Lobe Desiccated-Mulford (H. K. Mulford Co.). The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem.. 1930. p. 26. Pituitary Body (G. W. Carnrick Co.), Reports Council Pharm. & Chem., 1922, p. 52. Pituitary Body. Desiccated-Armour (Armour & Co.), The Journal, July 19, 1930. p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Pituitary Extract-Lederle 20 Units (Lederle Antitoxin Laboratories), The Journal, Aug. 17, 1929, p. 524; Reports Council Pharm. & Chem., "1929, p. 39. Pituitary Extract-Lilly (Surgical) (Eli Lilly & Co.), The Journal, Aug. 17, 1929. p. 524; Reports Council Pharm. & Chem.. 1929, p. 39. Pituitary Extract Surgical-Merrell (Wm, H. Merrell Co.), The Journal, Aug. 17, 1929, p. 524; Reports Council Pharm. & Chem., 1929, p. 30. BIBLIOGRAPHICAL INDEX xlvii Pituitary Extract Surgical-Mulford, Solution (See Solution Pituitary Extract-Mulford). Pituitary Liquid (Surgical)-Arraour (Armour & Co.). The Journal, Aug. 17, 1929, p. 524; Reports Council Pharm. & Chem., 1929, p. 39. Pituitary Posterior Desiccated (G. W. Carnrick Co.), Reports Council Pharm. & Chem., 1922, p. 52. Pituitary, Posterior, Desiccated-P.-M. Co.) (Pitman-Moore Co.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Pituitary Solution Surgical-Wilson (Wilson Laboratories), The Journal, Aug. 17, 1929, p. 524; Reports Council Pharm. & Chem., 1929, p. 39. Pituitary Solution-Squibb 1 cc. 5 Units (E. R. Squibb & Sons). The Journal, Jan. 1, 1930, p. 105; Reports Council Pharm. & Chem., 1929, p. 40. Pituitary Solution-Squibb 1 cc. 20 Units (E. R. Squibb & Sons), The Journal, Jan. 1, 1930, p. 105; Reports Council Pharm. & Chem.. 1929, p. 40. Pituitary Substance, Desiccated (Anterior Lobe) -Armour (Armour & Co.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Pituitary Substance, Posterior Desiccated-Lederle (Lederle Laboratories, Inc.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Pituitary Substance, Desiccated (Posterior Lobe) -Armour (Armour & Co.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 26. Pituitary, Whole, Desiccated-Lederle (Lederle Laboratories, Inc.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem.. 1930. p. 26. Pixalbol (E. Bilhuber, Inc.), The Journal, Nov. 22, 1924, p. 1704; Reports Council Pharm. & Chem., 1924, p. 51. Pix Cresol (Pix Cresol Chemical Co.), The Journal, June 10, 1911, p. 1738; Reports Chem. Lab., 1911, p. Z7 ; Propaganda, vol. 1, p. 247. Pixsul (The Pixsul Co.). The Journal, May 2, 1931, p. 1643. Plasmon (Plasmon Milk Products Co.), Reports Chem. Lab., 1914, p. 88. Piatt's Chlorides (Henry B. Piatt), The Journ.^l, March 27, 1920, p. 903; July 22, 1922, p. 319; Reports Chem. Lab., 1920, p. 28; Reports Council Pharm. & Chem., 1920, p. 8. Plurasav, Young's (The Plurasav Co., Columbus, Ohio), Reports Council Pharm. & Chem., 1918, p. 82. Pluto Spring Water, Concentrated (French Lick Springs Hotel Co.), The Journal, March 29, 1913, p. 1013. Ply »1, Ply if2, Ply #3 (Milburn Co.), The Journal, Oct. 12, 1935, p. 1191; Reports Council Pharm. & Chem., 1935, p. 93. Pneumococcus Antibody Solution Types I, II and III Combined (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1930, p. 55. Pneumococcus Antigen (Eli Lilly & Co.), The Journal, March 8, 1930, p. 716; Reports Council Pharm. & Chem., 1930, p. 35. Pneumococcus Immunogen Combined (Parke, Davis & Co.), The Jour- nal, Sept. 17, 1927, p. 984; Reports Council Pharm. & Chem., 1927. p. Z7. Pneumococcus Immunogen (Parke, Davis & Co.), The Journal, March 8, 1930, p. 716; Reports Council Pharm. & Chem., 1930, p. 55. Pneumococcus Serum-Lederle, Refined and Concentrated (Lederle Lab- oratories, Inc.), The Journal, Sept. 27, 1930, p. 935; Reports Council Pharm. & Chem., 1930, p. 55. Pneumococcus Vaccine (Eli Lilly & Co.), The Journal, March 8, 1930, p. 716; Reports Council Pharm. & Chem., 1930, p. 55. Pneumococcus Vaccine (E. R. Squibb & Sons), The Journal, March 8, 1930, p. 716; Reports Council Pharm. & Chem., 1930, p. 55. Pneumococcus Vaccine (Four Types) (Parke, Davis & Co.), The Journal, March 8, 1930, p. 716; Reports Council Pharm. & Chem., 1930, p. 55. Pneumococcus Vaccine Immunizing (Gilliland Laboratories, Inc.), The Journal, March 8, 1930, p. 716; Reports Council Pharm. & Chem., 1930, p. 55. Pneumococcus Vaccine (Lederle Laboratories, Inc.), The Journal, March 8, 1930, p. 716; Reports Council Pharm. & Chem., 1930, p. 55. xlviii BIBLIOGRAPHICAL INDEX Pneumococcus Vaccine (National Drug Co.), The Journal, March 8, 1930, p. 716; Reports Council Pharm. & Chem., 1930, p. 55. Pneumo. Mixed Vaccine No. 6 (G. H. Sherman). The Journal, Oct. 11, 1924, p. 1184; Reports Council Pharm. & Chem., 1924, p. 57. Pneumonia Sero (California Endocrine Foundation Laboratories), The Journal, July 5, 1924, p. 58. Pneumo-Strep-Serum (H. K. Mulford Co.), The Journal, Jan. 31, 1920, p. 342; Propaganda, vol. 2, p. 254. P-0-4 (Lehn & Fink, Inc.), The Journal, Sept. 13, 1924, p. 861; Reports Council Pharm. & Chem., 1924. p. 52. Poliomyelitis Vaccine, The Journal, Sept. 29, 1936, p. 716. Pollantin Liquid (Fritzsche Bros.), The Journal, Nov. 8, 1924, p. 1526; Reports Council Pharm. & Chem., 1924, p. 53. Pollantin Ointment (Fritzsche Bros.), The Journal, Nov. 8, 1924, p. 1526; Reports Council Pharm. & Chem., 1924, p. 53. Pollantin Powder (Fritzsche Bros.), The Journal, Nov. 8, 1924, p. 1526; Reports Council Pharm. & Chem., 1924. p. 53. Pollen Antigen (Lederle Antitoxin Laboratories), Reports Council Pharm. & Chem., 1918, p. 65. Pollen Antigen-Lederle (Fall Tvpe) (Lederle Antitoxin Laboratories), Reports Council Pharm. & Chem., 1921, p. 45. Pollen Antigen Spring Type-Lederle (Lederle Antitoxin Laboratories), Reports Council Pharm. & Chem., 1926, p. 48. Pollen Extract Ambrosiaceae (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1925, p. 60. Pollen Extract Artemisias (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1925, p. 60. Pollen Extract Chenopodiaceae (Parke, Davis & Co.), Reports Council Pharm & Chem., 1925, p. 60. Pollen Extract Gramineae (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1925, p. 60. Pompeian Olive Oil (Pompeian Corporation), The Journal, July 5, 1930, p. 35; Reports Council Pharm. & Chem., 1930, p. 56. Ponca Compound (Mellier Drug Co.), The Journal, July 17, 1915, p. 269; Reports Council Pharm. & Chem., 1912, p. 46; 1915, p. 58; Propaganda, vol. 2, p. 28. Ponndorf Cutaneous Vaccine B, The Journal, Oct. 8, 1932, p. 1283. Poslam (Emergency Laboratories), The Journal, May 22, 1909, p. 1678; Reports Chem. Lab., 1909, p. 25. Posterior Pituitary Desiccated-P.-M. Co, (Pitman-Moore Co.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930. p. 55. Posterior Pituitary Substance Desiccated-Lederle (Lederle Laboratories, Inc.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 55. Potassium lodo-Resorcin Sulphonate, The Journal, Feb. 11, 1911, p. 441; Reports Chem. Lab.. 1911. p. 21. Power Candy Mineralized (Granger Farms), The Journal, Oct. 27, 1928, p. 1289; Reports Council Pharm. & Chem., 1928, p. 49. Prehyiin-Chappcl (Chappel Bros., Inc.), The Journal, Aug. 31, 1935, p. 667. Presoiod. The Journal, Nov. 10, 1923, p. 1628. Probilin Pills (Schering & Glatz, Inc.), The Journal, Aug. 24, 1907, p. 702; Nov. 2 1907, p. 1541; Reports Council Pharm. & Chem., 1905-8, P. 70; Propaganda, ed. 9, p. 344. Progynon (Shering Corporation), The Journal, Aug. 31, 1935, p. 667. Progynon-B (Shering Corporation), The Journal, Aug. 31, 1935, p. 667. Progynon-B and the Ovarian Follicular Hormone, Reports Council Pharm. & Chem.. 1935. p. 95. Prolution (Shering Corporation), The Journal, Aug. 31, 1935, p. 667. Promonta (Acme Pharmaceutical Co.), The Journal, May 24, 1924, p. 1712; Reports Council Pharm. & Chem., 1924, p. 54. Propeptans (American Bio-Chemical Lab's, Inc.), Reports Council Pharm. & Chem., 1933, p. 144. Prostate Gland Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. BIBLIOGRAPHICAL INDEX xlix Proteals (Henry Smith Williams), The Journal, July 6, 1918, p. 58. Protein Substances No. 10 (Horovitz Biochemic Laboratories Co.), Thb Journal, Jan. 6, 1923, p. 54. Pro-Tek (DeVillbiss Co.), The Journal, Jan. 20, 1934, p. 211; Reports Council Pharm. & Chem., 1933, p. 147. Protonuclein (Reed & Carnrick Co.), The Journal, Oct. 5, 1907, p. 1198; Oct. 24, 1908, p. 1388; Jan. 1, 1916, p. 48; Reports Council Pharm. & Chem., 1905-8, p. 79; Reports Council Pharm. & Chem., 1915, p. 90; Propaganda, vol. 1, p. 348; Propaganda, vol. 2, p. 59. Protonuclein Beta (Reed & Carnrick Co.), The Journal, Jan, 1, 1916, p. 48; Reports Council Pharm. & Chem., 1915, p. 90; Propaganda, vol. 2, p. 59. Prunoids (Sultan Drug Co.), The Journal, April 30, 1910, p. 1458; Jan. 2, 1915, p. 71; Reports Council Pharm. & Chem., 1914, p. 133; Reports Chem. Lab., 1914, p. 63; Propaganda, vol. 1, pp. 178, 344. Pruritus Vaccine Treatment-Lederle (Montague Method) (Lederle Anti- toxin Laboratories), Reports Council Pharm. & Chem., 1924, p. 55. Psora (Pix Cresol Co.), Reports Council Pharm. & Chem., 1912, p. 39. Pulsatilla, Reports Council Pharm. & Chem., 1912, p. 44. Pulvane (Pulvane Laboratories, Inc.), The Journal, March 11, 1922, p. 750. Pulvoids, Calcylates (Drug Products Company), The Journal, Sept. 9, 1916, p. 827; Reports Council Pharm. & Chem., 1916, p. 18; Propa- ganda, vol. 2. p. 85. Pulvoids Calcylates Compound (The Drug Products Co., Inc.), The Journal, June 14, 1919, p. 1784; Reports Council Pharm. & Chem., 1919, p. 19; Propaganda, vol. 2, p. 226. Pulvoids Natrium Compound (Drug Products Company, Inc.), Reports Council Pharm. & Chem.. 1916, p. 69; Propaganda, vol. 2, p. 108. Pulv-Ora Throat Lozenges (Thiemann, Boettcher & Co., Inc.), Reports Council Pharm. & Chem., 1930. p. 58. Pulv-Ora Powder (Thiemann, Boettcher & Co., Inc.), Reports Council Pharm. & Chem., 1930, p. 58. Pulvules Amytal Compound (Lilly), The Journal, March 17, 1934, p. 842; Reports Council Pharm. & Chem., 1934. p. 88. Purgen (Lehn & Fink), The Journal, Jan. S, 1907, p. 64; Sept. 14, 1907, p. 954; Propaganda, vol. 1, p. 349. Pyo-atoxin (H. O. Hurley), The Journal, Feb. 14, 1914, p. 552; Reports Chem. Lab., 1914, p. 32; Propaganda, vol. 1, p. 350. Pyocyaneus Bacillus Vaccine, The Journal, May 18, 1918, p. 1486; Reports Council Pharm. & Chem., 1918, p. 11. Pyor-Chloride (Lindsey Laboratories, Inc.), Reports Council Pharm. & Chem., 1930, p. 59. Pyridium (Merck & Co.), The Journal, Dec. 30, 1933, p. 2118; Reports Council Pharm. & Chem., 1933, p. 148. Pyxol (Barrett Mfg. Co.), The Journal, Feb. 23, 1918, p. 599; Oct. 6, 1923, p. 1224. Quartonol Tablets (Schering & Glatz, Inc.), The Journal, Sept. 30, 1916, p. 1033; Reports Council Pharm. & Chem., 1916, p. 34; Propa- ganda, vol. 2, p. 94. Quassia Compound Tablets (Flint, Eaton and Company), The Journal, July 9, 1921, p. 141; Reports Council Pharm. & Chem., 1921, p. 64; Propaganda, vol. 2, p. 306. Queen of the Meadow, Reports Council Pharm. & Chem., 1912, p. 45. Quicamphol (Cheraisch-Pharmaceutische A.-G., Bad Homburg), The Journal, Nov. 9, 1929, p. 1471; Reports Council Pharm. & Chem., 1929, p. 40. Quina LaRoche (E. Fougera & Co., Inc.), The Journal, March 21, 1908. p. 978. Quinin Arsenate. The Journal, July 16, 1910, p. 325; Reports Council Pharm. & Chem., 1910, p. 7Z. Quinin Glycerophosphate, Reports Chem. Lab., 1912, p. 107. Radelium and Radelium Generator (Radio-Active Water Company), Reports Council Pharm. & Chem., 1915, p. 128. Radioactive Waters, The Journal, Sept. 7, 1929. p. 771. Radio-Rem (Radium Ore Revigator Co.), The Journal, March 31, 1928, p. 1039; Reports Council Pharm. & Chem., 1928, p. 51. 1 BIBLIOGRAPHICAL INDEX Radio-Rem Outfit No. 2 (Schieffelin & Co.), The Journal, Aug. 19, 1916, p. 631; Reports Council Pharm. & Chem., 1916, p. 9; Propa- ganda, vol. 2, p. 79. Radio-Rem Outfit No. 3 (Schieffelin & Co.), The Journal, Aug. 19, 1916, p. 631; Reports Council Pharm. & Chem., 1916, p. 9; Propa- ganda, vol. 2, p. 79. Radio-Rem Outfit C (Schieffelin & Co.), The Journal, Aug. 19, 1916, p. 631; Reports Council Pharm. & Chem., 1916, p. 9; Propaganda, vol. 2, p. 79. Radium Chloride (United States Radium Corporation), Reports Council Pharm. & Chem., 1928, p. 51. Radium Emanation Activator, Saubermann (See Saubermann Radium Emanation Activator). Radium Emanator, National (See National Radium Emanator). Radium, The Rental of. The Journal, May 18, 1929, p. 1678; Reports Council Pharm. & Chem., 1929, p. 51. Radium Solution for Intravenous Use Standard (Radium Chemical Co.). The Journal, June 26, 1915, p. 2156; Reports Council Pharm. & Chem., 1915, p. 147. Radolatum-Squibb, Reports Council Pharm. & Chem.. 1935, p. 97. Radolatum Liquid-Squibb, Reports Council Pharm. & Chem., 1935, p. 97. Rad-X-Solution A (Robert McKnight), The Journal, Sept. 4, 1926, p. 775; Reports Council Pharm. & Chem., 1926, p. 49. Rad-X-Solution B (Robert McKnight), The Journal, Sept. 4, 1926, p. 775; Reports Council Pharm. & Chem., 1926, p. 49. Rattlesnake-Venom, The Journal, March 15, 1913, p. 850; March 29, 1913, p. 1001; June 7. 1913, p. 1811. Raylos (Raylos Laboratories, Inc.), Reports Council Pharm. & Chem., 1934, p. 100. Rayminol (Doyle) (Phairmount Laboratories), The Journal, Oct. 17, 1925, p. 1241; Reports Council Pharm. & Chem., 1925. p. 62. Y^ Doctor's Prescription Powder (Dermic Laboratories), The Journal, July 15, 1933, p. 209; Reports Council Pharm. & Chem., 1933, p. 158. Recresal (Chemische Werke vorm. H. & E. Albert), The Journal, May 3, 1930, p. 1406; Reports Council Pharm. & Chem., 1930, p. 60. Red Bone-Marrow, Reports Council Pharm. & Chem., 1918, p. 69. Red Bone-Marrow-Armour, Extract of (Armour & Co.), Reports Council Pharm. & Chem., 1918, p. 69; Propaganda, vol. 2. p. 213. Redintol (Johnson & Johnson), The Journal, July 28, 1917, p. 306. Refistine (James A. Moore), The Journal, June 27, 1931, p. 2196 Reports Council Pharm. & Chem., 1931, p. 79. Resinol (Resinol Chemical Co.), The Journal, Nov. 6, 1909, p. 1578; Propaganda, vol. 1. p. 352. Resor-Bisnol (Resor-Bisnol Chemical Co.), The Journal, June 1, 1912 p. 1706; Reports Chem. Lab., 1912, p. 85; Propaganda, vol. 1. p. 353 Respirazone (The Tilden Company), The Journal, June 14, 1913, p 1899. Restor Vin (Robinson-Pettet Co.), The Journal. Jan. 3, 1925, p. 54; Reports Council Pharm. & Chem., 1924, p. 56. Rex-Orcin (Amp Research Laboratories), The Journal, July 22, 1933 p. 281; Reports Council Pharm. & Chem., 1933, p. 163. Rheum-Agar (Reinschild Chemical Co.), The Journal, Nov. 11, 1933 p. 29; Reports Council Pharm. & Chem., 1933, p. 29. Rheumalgine (Eli Lilly & Co.). The Journal, June 26, 1915, p. 2156; Reports Council Pharm. & Chem., 1915, p. 148; Propaganda, vol. 2. p. 23. Rheumatic Antigen No. 38 (Persson) (Persson Laboratories), Reports Council Pharm. & Chem., 1922, p. 62. Rheumatic Bacterin (Mixed), (No. 47), Swans' (Swan-Myers Co.), The Journal, Nov. 6, 1915, p. 1662; Reports Council Pharm. & Chem., 1915, p. 160, Rheumatism Sero (California Endocrine Foundation Laboratories), The Journal, July 5. 1924, p. 58. Rheumeez ((Tasco Laboratories), The Journal, July 11, 1925, p. 132; Reports Council Pharm. & Chem., 1925, p. 63. Rheume Olum (Rheumeolum Chemical Co.), The Journal, March 17, 1917, p. 865; Reports Council Pharm. & Chem., 1917. p. 19. BIBLIOGRAPHICAL INDEX H Rhodanate (Sodium Thiocyanate), The Journal, August 24, 1935, Ricinol-Grape Tape-Worm Remedy (Grape Capsule Co.), Reports Council Pharm. & Chem., 1915, p. 174. Riken Vitamin A Capsules (Adsole Company of America), Reports Council Pharm. & Chem., 1927, p. 48. Robes' Antirheumatic Injections (Robes' Intravenous Products Co.), The Journal, Sept. 12. 1925, p. 845; May 29, 1926, p. 1713; Reports Council Pharm. & Chem., 1926, p. 52. Robinol (John Wyeth & Bro.), The Journal, July 6. 1914, p. 49; Sept. 30, 1916, p. 1034; Reports Council Pharm. & Chem., 1916, p. 34; Propaganda, ed. 9, p. 353; Propaganda, vol. 2, p. 95. Robinson's Lime Juice and Pepsin (Robinson-Pettet Co., Inc.), Reports Council Pharm. & Chem., 1930. p. 62. Rossium (Medico Chem. Corp. of America), The Journal, September 7, 1935. p. 799; Reports Council Pharm. & Chem., 1935, p. 98. Russell Emulsion (The Standard Emulsion Co.), The Journal, June 23, 1917, p. 1931; Feb. 9, 1924, p. 489; Reports Council Pharm. & Chem., 1917, p. 29; Propaganda, vol. 2, p. 134. Russell Prepared Green Bone (The Standard Emulsion Co.), The Journal, June 23, 1917, p. 1931; Feb. 9, 1924, p. 489; Reports Council Pharm. & Chem., 1917, p. 29; Propaganda, vol. 2, p. 134. Sal-Codeia, Bell (Bell & Co^), The Journal, Nov. 4, 1905, p. 1422; Propaganda, ed. 9, p. 357. Sal Hepatica (Bristol-Meyers Co.), The Journal, March 26, 1910, p. 1071; Feb. 7, 1914. p. 427; April 12, 1919, p. 1078; Oct. 29, 1921, p. 1438; Reports Council Pharm. & Chem., 1914, p. 7; Reports Chem. Lab., 1921, p. 41; Propaganda, ed. 9, p. 179; Propaganda, vol. 2, p. 451. Sal Hyl (New York Salesthyl Corporation), The Journal, Feb. 20, 1915, p. 684; Reports Council Pharm. & Chem., 1915, p. 134. Salacetin (Bell & Co.), The Journal, June 3, 1905, p. 1791; Reports Council Pharm. & Chem., 1905-8, p. 8; Propaganda, vol. 1, p. 152. Salesthyl (New York Salesthyl Corporation), The Journal, Feb. 20, 1915, p. 684; Reports Council Pharm. & Chem., 1915, p. 134. Salicidol (H. A. Metz Laboratories, Inc.), The Journal, Sept. 5, 1925, p. 764; Reports Council Pharm. & Chem., 1925, p. 10. Salicionyl (Upjohn Co.), The Journal, May 20, 1933, p. 1597; Reports Council Pharm. & Chem., 1933, p. 31. Salicylic Acid, "Natural," The Journal, Sept. 20, 1913, p. 979; Reports Council Pharm. & Chem., 1913, p. 23. Salicyl-IsajDOgen (H. Seufert), Reports Council Pharm. & Chem., 1928, p. 34. Saligenin, Reports Council Pharm. & Chem., 1926, p. 53. Saline-Merammo (National Medical Research Laboratories), The Jour- nal, Dec. 22, 1923, p. 2123; Reports Council Pharm. & Chem., 1923, p. 29. Saliodin, (Saliodin Chemical Co.), The Journal, Oct. 26, 1907, p. 1453; Reports Council Pharm. & Chem., 1905-8, p. 95; Propaganda, ed. 9, p. 249. Salit (Hej'den Chemical Works), The Journal, June 5, 1909, p. 1852; Reports Council Pharm. & Chem., 1909, p. 106. Saloform (Robinson-Pettet Company), Reports Council Pharm. & Chem., 1916, p. 71; Reports Chem. Lab., 1916, p. 36; Propaganda, vol. 2, p. 110. Salv-Absorbs (Bio-Chemic Laboratories), The Journal, Feb. 25, 1922, p. 603; March 15, 1924, p. 888. Salvarols (Drug Products Co.), The Journal, July 26, 1924, p. 289. Sanajel (Evons Laboratories), The Journal, Sept. 23, 1933, p. 1020. Sanarthrit (Eastbrook. Inc.), The Journal, Feb. 11, 1928, p. 463; Reports Council Pharm. & Chem., 1928, p. 54. Sanatogen (Bauer Chemical Co.), The Journal, April 20, 1912, p. 1216; Dec. 6, 1913, p. 2085; March 28, 1914, p. 1035; Sept. 26, 1914, p. 1127; Reports Chem. Lab., 1912, p. 71; Propaganda, vol. 1, pp. 358, 378, 385. Sanguiodin (I-O-Dine Laboratories), The Journal, Feb. 20, 1932, p. 639; Reports Council Pharm. & Chem., 1932, p. 60. Hi BIBLIOGRAPHICAL INDEX Sanizone (Ho-Mo-Sol) (Sanox Co.), The Journal, August 24, 1935, p. 599. Sanmetto (The Old Chemical Co.), The Journal, July 8, 1905, p. 116; March 13, 1915, p. 926; Reports Council Pharm. & Chem., 1915, p. 17; Propaganda, vol. 1, p. 182. Sanocrysin, The Journal, Dec. 13, 1924, p. 1928; Feb. 13, 1926, p. 487. Sanol (Expurgo Mfg. Co.) — See Expurgo Anti-Diabetes. Santa] Midy Capsules (E. Fougera & Co.), The Journal, Oct. 9, 1920, p. 1016. Santoperonin, The Journal, Dec. 15, 1923, p. 2055. Saphanol Aromatic (Saphanol Products Co.), Reports Council Pharm. & Chem., 1921, p. 66. Saphanol Concentrate (Saphanol Products Co.), Reports Council Pharm. & Chem., 1921, p. 66. Sauberman Radium Emanation Activator (Radium Limited), The Jour- nal, April 6, 1929, p. 1181; Reports Council Pharm. & Chem., 1929, p. 36. Scopolamin-Morphin Mixtures, The Journal, Feb. 5, 1910, p. 446; Feb. 12, 1910, p. 516; June 7, 1913, p. 1814; Reports Council Pharm. & Chem., 1910, p. 11. Scott's Cod Liver Oil Concentrate Tablets (Scott & Bowne), The Jour- nal, June 22, 1935, p. 2256. Scott's Emulsion (formerly Scott's Emulsion of Cod Liver Oil) (Scott & Bowne), The Journal, June 22, 1935, p. 2256; Reports Council Pharm. & Chem., 1935, p. 103. Scott's Emulsion of Cod Liver Oil (Scott's Emulsion) (Scott & Bowne), The Journal, June 22, 1935, p. 2256. Secacornin (Hoffmann-LaRoche, Inc.), The Journal, May 4, 1929, p. 1521; Reports Council Pharm. & Chem., 1929, p. 26. Secretin-Beveridge (James Wallace Beveridge), The Journal, Jan. 12, 1918, p. 116; Reports Council Pharm. & Chem., 1917, p. 120; Propa- ganda, vol. 2, p. 170. Secretogen Elixir (G. W. Carnrick Co.), The Journal, Nov. 1, 1913, p. 1649; May 1, 1915, p. 1518; Sept. 9, 1916. p. 828; Reports Coun- cil Pharm. & Chem., 1915, p. 46; 1916, p. 72; Propaganda, vol. 1, p. 185; Propaganda, vol. 2, pp. 75, 110. Secretogen Tablets (G. W. Carnrick Co.), The Journal, Nov. 1, 1913, p. 1649; May 1, 1915, p. 1518; Jan. 15, 1916, pp. 178, 208; Sept. 9, 1916, p. 828; Reports Council Pharm. & Chem., 1915, pp. 46, 96, 99; 1916. p. 72; Propaganda, vol. 1, p. 185. Sedobrol "Roche" (Hoffmann-LaRoche Chemical Works), The Journal, Jan. 2, 1915, p. 71; Reports Council Pharm. & Chem., 1914, p. 134. Sedormid (Hoffmann-LaRoche, Inc.), The Journal, March 26, 1932, p. 1104. Seleni-Bascca (Cosmopolitan Cancer Research Society), The Journal, Nov. 19, 1921, p. 1672; Reports Chem. Lab., 1921, p. 55; Propa- ganda, vol. 2, p. 416. Semprolin (W. Browning & Co.), The Journal, July 10, 1915, p. 175. Seng (Sultan Drug Co.), Reports Council Pharm. & Chem., 1912, p. 42; 1915, p. 129; Propaganda, vol. 2, p. 55. Sepsis Bacterin No. 40 (Persson) (Persson Laboratories), Reports Coun- cil Pharm. & Chem., 1922, p. 62. Serenium (E. R. Squibb & Sons), The Journal, May 31, 1930, p. 1783. Serosaline (Davis-Johnson Co.), The Journal, March 31, 1928, p. 1064. Serum Vaccine, Bruschettini (R. G. Berlingieri), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 127. Servex (Burnham Snow Products Co.), The Journal, Feb. 4, 1933, p. 360. Sextonol Tablets (Schering & Glatz, Inc.), The Journal, Sept. 30, 1916, p. 1033; Reports Council Pharm. & Chem., 1916, p. 34; Propaganda, vol. 2. p. 94. Seven-Bark, Reports Council Pharm. & Chem., 1912, p. 45. Sevetol (John Wyeth & Bro.), The Journal, July 6, 1914, p. 49; Propa- ganda, ed. 9, p. 353. Shadocol (Davies, Rose & Co., Ltd.), The Journal, March 16, 1935, p. 922; Nov. 2, 1933, p. 1430; Reports Council Pharm. & Chem., 1935, p. 104; p. 106. BIBLIOGRAPHICAL INDEX liii Sherman's Mixed Vaccine No. 40. — See Mixed Vaccine No. 40, Sher- man's. Shotgun Vitamin Therapy, Reports Council Pharm. & Chem., 1935, p. 106. Simaruba-Agar (Reinschlld Chemical Co.), The Journal, Nov. 12, 1932, p. 1690; Reports Council Pharm. & Chem., 1932, p. 57. Sinkina (Metropolitan Pharmacal Co.), The Journal, Sept. 27, 1913, p. 1056; Reports Council Pharm. & Chem., 1913, p. 24; Propaganda, vol. 1, p. 188. Sirolin (Sirolin Co.), The Journal, June 21, 1913, p. 1974. Snake Venom Solution Moccasin (Lederle), Reports Council Pharm. & Chem., 1935, p. 112. Soamin Tabloid (Burroughs Wellcome & Co.), Reports Council Pharm. & Chem., 1919, p. 89; Propaganda, vol. 2, p. 253. Sodiphene (Sodiphene Company), The Journal, Aug. 3, 1929, p. 381; Reports Council Pharm. & Chem., 1929, p. 47. Sodium Arsphenamine, The Journal, July 6, 1935, p. 33; Reports Coun- cil Pharm. & Chem.. 1935, p. 116. Sodium Cacodylate, Ampules 7j^ grains (0.5 Gm.), ISJ^ grains (1.0 Gm.) for Intravenous Use (Cheplin Biological Lab's), The Journal, Dec. 23, 1933, p. 2050; Reports Council Pharm. & Chem., 1933, p. 13. Sodium Cacodylate for Intravenous Use, Ampoules-P. D. & Co. (Parke, Davis & Co.), The Journal, May 7, 1932, p. 1654; Reports Council Pharm. & Chem., 1932, p. 7. Sodium Carbonate and Sodium Chloride Mixture for making Fisher's Hypertonic Alkaline Solution (E. R. Squibb & Sons), Reports Coun- cil Pharm. & Chem., 1917, p. 147. Sodium Diarsenol (Diarsenol Co., Inc.), The Journal, July 6, 1935, p. 33; Reports Council Pharm. & Chem., 1935, p. 116. Sodium Dioxide Dental-R. & H., The Journal, April 22, 1933, p. 1237; Reports Council Pharm. & Chem., 1933, p. 29. Sodium Glycerophosphate, Reports Council Pharm. & Chem., 1916, p. 52; Propaganda, vol. 2, p. 99. Sodium Methylarsenate Ampules-De Marsico (De Marsico Laboratories, Inc.), Reports Council Pharm. & Chem., 1926, p. 54. Sodium Morrhuate, The Journal, March 8, 1924, p. 813; Sept. 27, 1924, p. 1022. Sodium Nitroprusside, The Journal, May 5, 1934, p. 1517. Sodium Peroxide-R. & H., The Journal, April 22, 1933, p. 1237; Reports Council Pharm. & Chem., 1933, p. 29. Sodium Salicylate, "Natural," The Journal, Sept. 20, 1913, p. 979; Reports Council Pharm. & Chem., 1913, p. 23. Sodium Thiocyanate (Rhodanate), The Journal, July 2, 1932, p. 58; July 28, 1933, p. 1237. Sodium Thiocyanate (Rhodanate), The Journal, August 24, 1935, p. 618. Soluble Iodine, Burnham's (Burnham Soluble Iodine Co.), The Journal, July 1, 1933, p. 33; Reports Council Pharm. & Chem., 1933, p. 26. Solution Hypophosphites of Lime and Soda, Schlotterbeck's (Liq. Hypo- phosphitum, Schlotterbeck's), (Schlotterbeck and Foss Co.), The Journal, Sept. 2, 1916, p. 761; Reports Council Pharm. & Chem., 1916, p. 14; Propaganda, vol. 2, p. 83. Solution Normet "Medical" and "Surgical" (High Chemical Co.), The Journal, Oct. 17, 1931, p. 1149; Jan. 30, 1932, p. 401; July 22, 1933, p. 281; Reports Council Pharm. & Chem., 1931, p. 86; 1932, p. 66; 1933, p. 164. Solution of Post Pituitary (G. W. Carnrick Co.), Reports Council Pharm. & Chem., 1925, p. 19. Solution Pituitary Extract Surgical-Mulford (H. K. Mulford Co.), The Journal, Aug. 17, 1929, p. 524; Reports Council Pharm. & Chem., 1929, p. 39. Solvo-Aspirin (Ess & Arch Co.), The Journal, Jan. 21, 1928, p. 205; Reports Council Pharm. & Chem., 1927, p. 50. Solvochin (Spicer & Co.), The Journal, May 2, 1931, p. 1577; Reports Council Pharm. & Chem., 1931, p. 88. Somnacetin (Reidar G. Seel), Reports Council Pharm. & Chem., 1923, p. 63. liv BIBLIOGRAPHICAL INDEX Somnacetin Soluble (Reidar G. Seel), Reports Council Pharm. & Chem., 1923, p. 63. Somnoform (Stratford-Cookson Co.). Reports Council Pharm. & Chem., 1919, p. 90; Propaganda, vol. 2, p. 255. Somnos (H. K. Mulford Co.), The Journal, Sept. 15, 1906, pp. 863, 872; Sept. 29, 1906, p. 1033; Reports Council Pharm. & Chem., 1905-8, p. 12; Propaganda, vol. 1, p. 193. Sourwood, Reports Council Pharm. & Chem., 1912, p. 45. Sourwood Compound, Elixir (Eli Lilly & Co.), Reports Council Pharm. & Chem., 1912, p. 45. Spasmolysin (H. H. Beisner), The Journal, June 30, 1934, p. 2184; Reports Council Pharm. & Chem.. 1934, p. 24. Special Pertussis Vaccine (Cutter Laboratory), The Journal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Spermin, Poehl (Prof. Dr. v. Poehl & Soehne), The Journal, April 15, 1911, p. 1132; Propaganda, ed. 9, p. 395. Spin-L-Ron (Ford Pharmacal Co.), The Journal, March 14, 1931, p. 860; Reports Council Pharm. & Chem., 1931, p. 85. Spirocide (The Spirocide Corp.), The Journal, Jan. 22, 1921, p. 259; July 30, 1921, p. 394; Reports Chem. Lab., 1920, p. 58; Reports Council Pharm. & Chem., 1920, p. 46; Propaganda, vol. 2, p. 296. Spleen Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Spleen Solution, 500% (Rovin), (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Squaw-Vine, Reports Council Pharm. & Chem., 1912, p. 45. Squaw-Vine and Black-Haw Compound, Elixir (Eli Lilly & Co.), Reports Council Pharm. & Chem., 1912, p. 46. Squibb Adex Tablets (E. R. Squibb & Sons), The Journal, March 19, 1932, p. 983; Reports Council Pharm. & Chem., 1932, p. 69; 1934, p. 122. Stannoxyl (E. Fougera & Co.), The Journal, March 6, 1920, p. 692; Propaganda, vol. 2, p. 469. Stanolind Liquid Paraffin (Standard Oil Company of Ind.), Reports Council Pharm. & Chem., 1918. p. 72; Propaganda, vol. 2, p. 214. Staph-Acne Vaccine (Cutter Laboratory), Reports Council Pharm. & Chem., 1925, p. 8. Steere's Elixir Aspirin Compound (American Laboratories, Inc.), The Journal, May 1, 1926, p. 1713; Reports Council Pharm. & Chem., 1926, p. 55. Steere's Elixir Ammonium Salicylate (American Laboratories, Inc.), The Journal, May 1, 1926, p. 1/'13; Reports Council Pharm. & Chem., 1926, p. 55. Ster-Alco (Dawson Chemical Co.), Reports Council Pharm. & Chem., 1926. p. 57. Sterile Solution Iron Citrate (Green) (Intra Products Co.), Reports Council Pharm. & Chem., 1922, p. 53. Sterile Solution Mercury Bichlorid (Intra Products Co.), Reports Coun- cil Pharm. & Chem., 1922. p. 53. Sterile Solution of Lutein-H. W. & D. (Hynson, Westcott & Dunning), The Journal, Jan. 30, 1932, p. 402; Reports Council Pharm. & Chem., 1932, p. 55. Sterility of Ampule Preparations, Report on, Reports of Council Pharm. & Chem., 1935, p. 111. Ster-Tabs (J. Sklar Mfg. Co.). The Journal, Dec. 21, 1929, p. 1993. Stillingia Compound, Elixir (Hance Bros. & White), Reports Council Pharm. & Chem., 1912, p. 47. Stillingia Compound, Elixir (Ray Chemical Co.), Reports Council Pharm. & Chem.. 1912, p. 47. Stillingia Compound. Elixir (Smith, Kline & French Co.), Reports Coun- cil Pharm. & Chem., 1912, p. 47. Stillingia Compound, Fluidextract (H. K. Mulford Co.), Reports Coun- cil Pharm. & Chem., 1912. p. 42. Stone Root. Reports Council Pharm. & Chem., 1912. p. 46. Stovaine (George J. Wallau, Inc.), Reports Council Pharm. & Chem., 1928, p. 57. Street Dust Allergen-Squibb (E. R. Squibb & Sons), The Journal, Nov. 7, 1925, p. 1504; Reports Council Pharm. & Chem., 1925, p. 27. BIBLIOGRAPHICAL INDEX Iv Streptococcus Immunogen (Parke, Davis & Co.), The Journal, Sept 17, 1927, p. 984; Reports Council Pharm. & Chem., 1927, p. 37. Streptococcus Immunogen Combined (Parke, Davis & Co.). The Jour- nal, Sept. 17, 1927, p. 984; Reports Council Pharm. & Chem., 1927, p. 37. Streptococcus-Rheumaticus-Combined-Bacterin (The Abbott Laboratories), The Journal, June 22. 1918, p. 1967; Reports Council Pharm. & Chem., 1918, p. 11; Propaganda, vol. 2, p. 186. Streptococcus Vaccine, The Journal, Jan. 23, 1926, p. 294; Reports Council Pharm. & Chem., 1925, p. 70. Streptococcus-Viridans-Combined-Bacterin (The Abbott Laboratories), The Journal, June 22, 1918. p. 1967; Reports Council Pharm. & Chem., 1918, p. 11; Propaganda, vol. 2, p. 186. Streptocoll (The Soshokee Co.), The Journal, Sept. 19, 1931, p. 853; Reports Council Pharm. & Chem., 1931, p. 89. Strepto. Staph. Vaccine No. 10 (G. H. Sherman), The Journal, Oct. 11, 1924, p. 1184; Reports Council Pharm. & Chem., 1924, p. 57. Stronger Thorium Sodium Citrate Solution, Reports Council Pharm. & Chem., 1927. p. 96. Strychnin Arsenate, The Journal, Sept. 24, 1910, p. 1128; Reports Council Pharm. & Chem., 1910, p. 74. Stypticin, The Journal, Nov. 22, 1919, p. 1628; Reports Council Pharm. & Chem., 1919, p. 48; Propaganda, vol. 2, p. 240. Styptol (E. Bilhuber), The Journ.\l, Nov. 22, 1919, p. 1628; Reports Council Pharm. & Chem., 1919, p. 48; Propaganda, vol. 2, p. 240. Stypsticks (Tappan Zee Surgical (To.), The Journal, May 19, 1934, p. 1681; Reports Council Pharm. & Chem., 1934, p. 68. Styptysate (Ernst Bischoff Co., Inc.), The Journal, Feb. 11, 1922, p. 450. Subenon (Seydel Chem. Co.), The Journal, Sept. 12, 1936, p. 878; Sept. 26, 1936, p. 1056. Subidin (I-O-Dine Laboratories), The Journal, Feb. 20, 1932, p. 639; Reports Council Pharm. & Chem,, 1932, p. 60. Succinolac (Succinolac Company), Reports Council Pharm, & Chem., 1916, p. 79. Succus Alterans (Eli Lilly & Co.), The Journal, June 26, 1909, p. 2115; Reports Council Pharm. & Chem., 1909, p. 107; Propaganda, vol. 1, p, 195. Succus Cineraria Maritima- Walker (Walker Pharmacal Co.), The Jour- nal, Nov. 11, 1911, p. 1630; March 17. 1917, p. 864; Dec. 20, 1924, p. 2040; Reports Council Pharm, & Chem., 1911, p. 48; Propaganda, vol. 1, p. 50; Propaganda, vol. 2, p. 455. Sukro-Serum (Anglo-French Drug Co.), The Journal, Aug. 21, 1920, p. 556; Reports Council Pharm. & Chem., 1920, p. 23; Propaganda, vol. 2, p. 273. Sulfuryl Monal (Geo. J. Wallau, Inc.), The Journal, Sept. 16, 1916, p. 895; Reports Council Pharm. & Chem., 1916, p. 22; Reports Chem. Lab., 1916, p. 23; Propaganda, vol. 2, p. 86. Sulcitacium (Davis-Johnson Co.), The Journal, July 10, 1926, p. 116; Reports Council Pharm. & Chem., 1926, p. 58. Sulfobetin (Alex Friedman & Co.), The Journal, June 13, p. 2036; Reports Council Pharm. & Chem., 1931, p. 90. Sulphocol (American Chemical Laboratories), The Journal, Aug. 23, 1930, p. 594; Reports Council Pharm. & Chem., 1930, p. 72. Sulphocol Sol (American Chemical Laboratories), The Journal, Aug. 16, 1930, p. 935; Reports Council Pharm. & Chem., 1930, p. 72. Sulpho-Ichthyolate of Ammonium (American Ichthyol) (American Ichthyol Syndicate), Reports Council Pharm. & Chem., 1930, p. 74. Slupho-Lythin (Laine Chemical Co.), The Journal, Dec. 8, 1906, p. 1930; Reports Council Pharm. & Chem., 1905-8, p. 34; Propaganda, vol. 1, p. 196. Sulpho-Selene (C. H. Walker), The Journal, April 17, 1915, p. 1283; Dec. 16, 1915, p. 1864; Reports Council Pharm. & Chem., 1915, p. 28; 1916, p. 80; Reports Chem. Lab.. 1921, p. 56. Super D Cod Liver Oil (Upjohn Co.). The Journal, May 20, 1933, p. 1597; Reports Council Pharm. & Chem., 1933, p. 31. Suprarenal Cortex Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem,, 1933, p. 166, Ivi BIBLIOGRAPHICAL INDEX Suprarenal Gland Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Supsalvs (Anglo-French Drug Co.), The Journal, Oct, 30, 1920, p. 1219; March 15, 1924, p. 888; Reports Council Pharm. & Chem., 1920, p. 25; Propaganda, vol. 2, p. 274. Surgodine (Sharpe & Dohme), The Journal, Jan. 26, 1918, p. 257; Reports Council Pharm. & Chem., 1917, p. 134; Reports Chem. Lab., 1917, p. 59; Propaganda, vol. 2, p. 180. Synephrin Tartrate (Frederick Stearns & Co.), Reports Council Pharm. & Chem., 1934, p. 124. Synthalin, The Journal, Jan. 21, 1928, p. 209; March 4, 1933, p. 687. Syphilodol (French Medicinal Company, Inc.), The Journal, May 18, 1918, p. 1485; Propaganda, vol. 2, pp. 359, 470. Syrup of Ammonium Hypophosphite, Gardner's (R. W. Gardner), Reports Council Pharm. & Chem., 1916, p. 55; Propaganda, vol. 2, p. 100. Syrup Cocillana Compound (Parke, Davis & Co.), The Journal, March 18, 1911, p. 834; Feb. 15, 1913, p. 537; Reports Council Pharm. & Chem., 1912, p. 43; Propaganda, vol. 1, p. 396. Syrup Emetic-Lilly (Eli Lilly & Co.), Reports Council Pharm. & Chem., 1918, p. 52; Propaganda, vol. 2, p. 203. Syrup of Hydriodic Acid, (Gardner's (R. W. Gardner), The Journal, Nov. 14, 1908, p. 1712; Reports Council Pharm. & Chem., 1905-8, p. 200; Propaganda, vol. 1, p. 97. Syrup of the Hypophosphites Comp. (Lime and Soda), McArthur's (McArthur Hypophosphite Co.), The Journal, Sept. 2, 1916, p. 761; Reports Council Pharm, & Chem., 1916, p. 16; Propaganda, vol. 2, p, 84, Syrup Leptinol (Balsamea Co,), The Journal, June 5, 1920, p, 1591; Reports Council Pharm. & Chem., 1920, p. 15; Propaganda, vol. 2, p. 268. Syrup of Malt Williams' (American Malt Extract Co.), The Journal, Sept. 4, 1915, p, 895; Reports Council Pharm. & Chem., 1915, p. 155. Syrupus Roborans (Syrup Hypophosphites Comp. with Quinin, Strych- nin and Manganese) (Arthur Peter & Co.), The Journal, Sept. 2, 1916, p. 760; Reports Council Pharm. & Chem., 1916, p. 14; Propa- ganda, vol. 2, p. 82. Tabellae Dukes Heroin (Western) (Western Chemical Co., Inc.), Reports Council Pharm, & Chem,, 1925, p. 71, Tabellae Dukes Terpin Hydrate with Heroin (Western) (Western Chem- ical Co,), Reports Council Pharm. & Chem., 1925, p. 71. Tabes Sero (California Endocrine Foundation Laboratories), The Jour- nal, July 5, 1924, p. 58. Tablets Cakreose with Iodine (Maltbie Chemical CoO, The Journal, Jan. 31, 1925, p, 288; Reports Council Pharm. & Chem., 1925, p. 71, Tablets Cascara Comp, (Killgore's) (Chas. Killgore), The Journal, March 8, 1924, p. 812; Reports Council Pharm. & Chem., 1924, p. 46. Tablets Formothalates (Tailby-Nason Company), Reports Council Pharm, & Chem,, 1919, p. 92; Propaganda, vol, 2, p, 256. Tablets Kacyan McNeil, The Journal, June L 1929, p, 1838; Reports Council Pharm. & Chem., 1929, p. 58. Tablets of Benzyl Succinate-H, W, & D., The Journal, March 4, 1933, p, 661; Reports Council Pharm. & Chem., 1933, p. 22, Tablets Parathyroids with Calcium (Armour & Co.), Reports Council Pharm, & Chem., 1925, p. 60. Tablogestin (F, H. Strong Co,), The Journal, Dec. 11, 1915, p. 2108, "Tabknoll" (H. G, Knoll & Co,), Reports Council Pharm. & Chem., 1930, p. 79. Taka-Diastase (Parke, Davis & Co.), The Journal, July 11, 1908, p. 140; July 6, 1912, p. 50; Reports Council Pharm. & Chem., 1905-8, p. 110; 1912, p. 14; Propaganda, vol. 1, p. 62, Taka-Diastase, Liquid (Parke, Davis & Co.), The Journal, July 11, 1908, p. 140; July 6, 1912, p. 50; Reports Council Pharm. & Chem,, 1905-8, p. 110; 1912, p. 14; Propaganda, vol, 1, p, 62. Tamerci Salts (Banfi Products Corp,), The Journal, July 27, 1929, p. 283; Reports Council Pharm. & Chem,, 1929, p. 48. BIBLIOGRAPHICAL INDEX Ivii Tannin Agar (Reinschild Chemical Co.), The Journal, Nov. 12, 1932, p. 1690; Reports Council Pharm. & Chem., 1932, p. 57. Tannyl (Charles Goslar), Reports Chem. Lab., 1912, p. 108. Tar-Me-Cine (Tar-Me-Cine Laboratories, Inc.), The Journal, July 2, 1932, p. 34; Reports Council Pharm. & Chem.. 1932, p. 77. Tartarlithine (Tartarlithine Co., McKesson & Robbins), The Journal, April 13, 1907, p. 1284; Propaganda, vol. 1. p. 401. Taurocol Tablets (Paul Plessner Company), The Journal, April 24, 1915, p. 1441; Reports Council Pharm. & Chem., 1915, p. 143; Prop- aganda, ed. 9, p. 198. Taurocol Compound Tablets (Paul Plessner Company), The Journal, April 24, 1915, p. 1441; Reports Council Pharm. & Chem., 1915, p. 143; Propaganda, vol. 1, p. 198. Tekarkin (National Bio-Chemical Laboratory), The Journal, May 28, 1921, p. 1514; Nov. 19, 1921. p. 1675; Propaganda, vol. 2, p. 458. Telatuten (Eastbrook, Inc.), The Journal, Feb. 11, 1928, p. 464; Reports Council Pharm. & Chem., 1928, p. 54. Terpezone (Knox Terpezone Co.). The Journal, April 14, 1928, p. 1197; Reports Council Pharm. & Chem., 1928, p. 59. Terpin Hydrate with Codein Sulphate, Elixir, The Journal, April 15, 1916, p. 1199. Terraline with Agar Agar (Hillside Chemical Co.), The Journal, May 30. 1925, p. 1682. Tersul Hiller (Robert Wolheim). The Journal, May 24, 1924, p. 1712; Reports Council Pharm. & Chem., 1924, p. 62. Testacoids (Reed and Carnrick), The Journal. Feb. 5, 1927. p. 422. Tetradol (National Aniline & Chemical Co.)^ Reports Council Pharm. & Chem.. 1926, p. 60. Tetraiodophthalein Sodium-"Nationar' (National Aniline & Chemical Co.), Reports Council Pharm. & Chem., 1926, p. 60. Thalosen (The Abbott Laboratories), The Journal, April 30, 1910, p. 1458; Propaganda, vol. 1, p. 344. Thermozine (Pasteur Chemical Co.), The Journal, May 19, 1917, p. 1497; Propaganda, vol. 2, pp. 332, 334. Thialion (Vass Chemical Co.), The Journal, Nov. 3. 1906, p. 1500; Reports Council Pharm. & Chem., 1905-8, p. 26; Propaganda, vol. 1, p. 205; Propaganda, vol. 2, p. 470. Thio-Albin (Thiophene Laboratories, Inc.). The Journal, May 6, 1933, p. 1404; Reports Council Pharm. & Chem.. 1933. p. 170. Thioform (Otto Hann & Bro.). Reports Chem., Lab., to 1909, p. 79. Thioglycerol Solution 1:50 (Abbott), Reports Council Pharm. & Chem.. 1935, p. 119. Thiosinamine, Reports Council Pharm. & Chem., 1933, p. 173. Thorium Sodium Citrate Solution, Reports Council Pharm. & Chem., 1927, p. 96. Thorium Solution for Cystography-H. W. & D. (Hynson, Westcott & Dunning), Reports Council Pharm. & Chem., 1927, p. 96. Thorium Solutic^ for Pyelography-H. W. & D. (Hynson, Westcott & Dunning), Reports Council Pharm. & Chem., 1927, p. 42. Thoxos (John Wyeth & Bro.), The Journal, March 21, 1914, p. 949; Reports Chem. Lab., 1914, p. 41; Propaganda, vol. 1, p. 402. Three Bromides Eflfervescent "Knoll Brand" (H. G. Knoll & Co.), Reports Council Pharm. & Chem., 1930, p. 79. Three Chlorides (Henry), (Henry Pharmacal Co.), The Journal, Feb. 6, 1915, p. 528; Reports Council Pharm. & Chem., 1915, p. 9; Reports Chem. Lab., 1914, p. 65; Propaganda, vol. 1, p. 198. Thromboplastin-Lederle (for Hypodermic Injection) (Lederle Labora- tories, Inc.), The Journal, Jan. 9, 1932, p. 143; Reports Council Pharm. & Chem.. 1932, p. 89. Thromboplastin Hypodermic-Squibb (E. R. Squibb & Sons), The Jour- nal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1931, p. 94. Thromboplastin Solution-Armour (Armour & Co.), The Journal, May 18. 1935. p. 1824. Thromboplastic Substances, The Journal, May 18, 1935, p. 1824; Reports Council Pharm. & Chem.. 1935, p. 120. Tbyangol Pastilles (Sterling Products Co.), The Journal, Oct. 20, 1928, p. 1193; Reports Council Pharm. & Chem., 1928, p. 641. Iviii BIBLIOGRAPHICAL INDEX Thymo-Borine (Thymo-Borine Laboratory), Reports Council Pharm. & Chem., 1926, p. 67. Thymophysin Temesvary (American Biochemical Laboratory), The Journal, Jan. 31, pp. 352, 359; March 14, p. 860; Reports Council Pharm. & Chem., 1931, p. 95. Thymus Gland, Reports Council Pharm. & Chem., 1918, p. 69. Thymus-Gland-Armour, Desiccated (Armour & Co.), Reports Council Pharm, & Chem., 1918, p. 69; Propaganda, vol. 2, p. 213. Thymus Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25, 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Thyroid Solution (Rovin) (A. M. Rovin Lab's), The Journal, Feb. 25. 1933, p. 574; Reports Council Pharm. & Chem., 1933, p. 166. Thyroidectin (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1918, p. 50; Propaganda, vol. 2, p. 202. "Thysul" (Thysul Co.), Reports Council Pharm. & Chem., 1933, p. 174. Tissue Phosphates, Wheeler's (T. B. Wheeler, M.D., Company), The Journal, May 5, 1917, p. 1336; Sept. 22, 1917, p. 1010; Reports Council Pharm. & Chem., 1917, p. 21; Reports Chem. Lab., 1917, p. 13; Propaganda, vol. 2, pp. 129, 463. Tolysin (Calco Chemical Co.), The Journal, April 26, 1924, p. 1381; April 9, 1932, p. 1322; Reports Council Pharm. & Chem., 1924, p. 73. Tonga, The Journal, May 10, 1913, p. 1477; Reports Council Pharm. & Chem., 1912, p. 46. Tonga Compound, Elixir (Hance Bros. & White), The Journal, May 10, 1913, p. 1478; Reports Council Pharm. & Chem., 1912, p. 47. Tonga Compound, Elixir (Eli Lilly & Co.), The Journal, May 10, 1913, p. 1478; Reports Council Pharm. & Chem., 1912. p. 47. Tonga Compound, Elixir (Wm. S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 46. Tonga Compound, Elixir (Nelson, Baker & Co.), The Journal, May 10, 1913, p. 1478; Reports Council Pharm. & Chem., 1912, p. 46. Tonga Compound, Elixir (Parke, Davis & Co.), The Journal, May 10, 1913, p. 1478. Tonga Compound (Special), Elixir (Parke, Davis & Co.), Reports Coun- cil Pharm. & Chem., 1912, p. 47. Tonga Compound, Elixir (Ray Chemical Co.), The Journal, May 10, 1913, p. 1478; Reports Council Pharm. & Chem., 1912, p. 47. Tonga Compound, Elixir (F. Stearns & Co.), The Journal, May 10, 1913, p. 1478; Reports Council Pharm, & Chem., 1912, p. 47. Tonga Compound, Elixir (Wm. R. Warner & Co.), The Journal, May 10, 1913, p. 1478. Tonga-Salicyl (H. K. Wampole & Co.). The Journal, May 10, 1913, p. 1478; Reports Council Pharm. & Chem., 1912, p. 47. Tonga Salicylates, Elixir (Wm, S. Merrell Chemical Co.), The Journal, May 10, 1913, p. 1478, Tonga and Salicylates, Elixir (Sharp & Dohme), The Journal, May 10, 1913, p, 1478; Reports Council Pharm, & Chem,, 1912, p. 47. Tongaline (Mellier Drug Co.), The Journal, May 10, 1913, p. 1477; July 17, 1915, p. 269; March 2. 1918, p. 643; Reports Council Pharm. & Chem., 1912, p. 47; 1915, p. 58; Propaganda, vol. 2, p. 27. Tongaline and Quinine Tablets (Mellier Drug Co.), The Journal, July 17, 1915. p. 269. Tonic Beef, S. & D. (Sharp & Dohme), The Journal, May 11, 1907, p. 1612; Reports Council Pharm. & Chem., 1905-8, opp. p. 64; Propa- ganda, vol. 1, p. 133. "Tonikum"-Roche (Elixir Arsylen Compositum-Roche) (Hoffmann-La Roche, Inc.), The Journal, Jan. 9, 1932, p. 143; Reports Council Pharm. & Chem., 1932, p. 90. Tonols (Schering's Glycerophosphates), (Schering & Glatz, Inc.), The Journal, Sept. 30, 1916, p. 1033; Reports Council Pharm. & Chem., 1916, p. 34; Propaganda, vol. 2, p. 94, Tophrin Tablets (Bram Chemical Co.), The Journal, Jan. 28, 1928, p. 293; Reports Council Pharm. & Chem., 1927, p 97 Toxicide (Toxicide Laboratories), The Journal, Oct. 8, 1921, p. 1197; Reports Council Pharm. & Chem., 1921, p. 68; Propaganda, vol. 2, p. 307. Toxinol (Hughes Chemical Co.), The Journal, Dec. 2, 1916, p. 1687; Reports Council Pharm. & Chem., 1912, p. 39; 1916, p. 38. BIBLIOGRAPHICAL INDEX lix Toxivi (Cutter Laboratory), The Journal, Oct. 16, 1926, p. 1321; Reports Council Pharm. & Chem., 1926, p. 68. Toxogon (Von Winkler Laboratories, Inc.), The Journal, Nov. 2, 1929, p. 1393; Reports Council Pharm. & Chem., 1929, p. S3. Toxok (Cutter Laboratory), The Journal, Oct. 16, 1926, p. 1321; Reports Council Pharm, & Chem., 1926, p. 68. Transpulmin (See Quicamphol). Transkutan (Transkutan, Inc.), The Journal, June 9, 1928, p. 1889. Treparsol, The Journal, Dec. 7, 1929, p. 1830. Trepol (Anglo-French Drug Co.), The Journal, Jan. 9, 1926, p. 136; Reports Council Pharm. & C)hera., 1925, p. 75; Reports Chem. Lab., 1924-5, p. 36. Tri-Arsenole (Medical Supply Co.), Reports Council Pharm. & Chem., 1917, p. 156; Propaganda, vol. 2, p. 163. Tricalcine (Laboratorie des "Produits Scientia"), The Journal, March 14, 1925, p. 836; Reports Council Pharm. & Chem., 1925, p. 78. Trichlorethylene, The Journal, Feb. 8, 1936, p. 485; Reports Council Pharm. & Chem., 1936, p. 99. Trifolium Compound, Extract (Wm. S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 39. Trifolium Compound, Fluidextract (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 40. Trifolium Compound, Syrup (Hance Bros. & White), Reports Council Pharm. & Chem., 1912, p. 39. Trifolium Compound, Syrup (Eli Lilly & Co.), Reports Council Pharm. & Chem., 1912, p. 39. Trifolium Compound, Syrup (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912, p. 39. Trifolium Compound, Syrup (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 39. Trifolium Compound, Syrup (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 40. Trifolium Compound, Syrup (F. Stearns & Co.), Reports Council Pharm. & Chem., 1912, p. 40. Trifolium Compound with Cascara Syrup (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 40. Tri-Iodides (Henry) (Henry Pharmacal Co.). The Journal, Feb. 6, 1915, p. 528; Reports Council Pharm. & Chem., 1915, p. 9; Reports Chem. Lab., 1914, p. 65; Propaganda, vol. 1, p. 198. Trilene Tablets, Reports Council Pharm. & Chem., 1912, p. 39. Trimethol (Thos. Leeming & Co.). The Journal, Aug. 11, 1917, p. 485; Reports Council Pharm. & Chem., 1917, p. 43; Propaganda, vol. 2, p. 140; The Journal, Oct. 6, 1923, p. 1224. Triophos (Lehn & Fink, Inc.), Reports Council Pharm. & Chem., 1926, p. 69; Reports Chem. Lab., 1924-5, p. 164. Triotonol Tablets, The Journal, Oct. 6, 1923, p. 1224, (Schering & Glatz, Inc), The Journal, Sept. 30, 1916, p. 1033; Reports Council . Pharm. & Chem., 1916, p. 34; Propaganda, vol. 2, p. 94. Triple Arsenates with Nuclein (Abbott Laboratories), Reports Council Pharm. & Chem., 1919, p. 92; Propaganda, vol. 2, p. 256. Tripp's Liquor Rheumatica, The Journal, Jan. 31, 1925, p. 390; Reports Chem. Lab., 1924-5, p. 147. Trophonine (Reed & Carnrick Co.), The Journal, Oct. 5, 1907, p. 1198; Reports Council Pharm. & Chem., 1905-8, p. 79. Trypsogen (G. W. Carnrick Co.), The Journal, Nov. 1, 1913, p. 1649; July 31, 1926, p. 345; Propaganda, vol. 1, p. 403; Reports Council Pharm. & Chem., 1925, p. 21. Tryptoferm (S. Kirsch Import Co.), Reports Council Pharm. & Chem., 1932, p. 97. Tubercle Bacilli Emulsion Polygeneous (Farbwerke-Hoechst Co.), Re- ports Council Pharm. & Chem., 1917, p. 146. Tubercle Bacilli Triturated (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tubercle Germs, Dried Dead (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tubercle Vaccine, Sherman's Non- Virulent (G. H. Sherman), The Jour- nal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 128. Ix BIBLIOGRAPHICAL INDEX Tuberculin, Bovine (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculin, Bovine, T. R. (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculin, "Koch" New (T. R.) (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculin "Koch" (Old) (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculin Old, Bovine (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculin Residue (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculin-Rosenbach (Kalle Color & Chemical Co.), Reports Council Pharm. & Chem., 1917, p. 161. Tuberculin Test Plate, Keller's (A. H. Keller), The Journal, Dec. 19, 1914, p. 2250. Tuberculin T. O. A. (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculin, Vacuum (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculin, Vacuum Bovine (Farbwerke-Hoechst Co.), Reports Council Pharm, & Chem., 1917, p^. 146. Tuberculoids (Columbus Pharmacal Co.), The Journal, Feb. 22, 1908, p. 704. Tuberculosis-Diagnostic "Hoechst" (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculosis-Diagnostic "Hoechst" Dry in Tubes (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculosis-Diagnostic "Hoechst" (0.1 per cent) Solution (Farbwerke- Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 146. Tuberculosis Serum Vaccine "Hoechst" (Farbwerke-Hoechst Co.), Reports Council Pharm. & Chem., 1917, p. 161. Tuberculosis Treatment (Spahlinger), The Journal, Oct. 7, 1922, p. 1263. Tubo-Arg (Tubo Pharmacal Co.), Reports Council Pharm. & Chem., 1915, p. 175. Turpedine (R. G. Dunwody & Sons), Reports Council Pharm. & Chem., 1931, p. 92. Turkey Corn, Reports Council Pharm. & Chem., 1912, p. 47. Tusi (Brewer & Co., Inc.), Reports Council Pharm. & Chem., 1928, p. 65. Tyramine Hydrochloride, Reports Council Pharm. & Chem., 1935, p. 126. Tyramine-Roche (Hoffmann LaRoche, Inc.), The Journal, June 24, 1933, p. 2009; Reports Council Pharm. & Chem., 1933, p. 175. Ulax Salt (F. H. Strong Co.), Reports Council Pharm. & Chem., 1915, p. 175. Unctol (R. R. Rogers Chemical Co.), Reports Council Pharm. & Chem., 1917, p. 162; Propaganda, vol. 2, p. 166. Unguentine (Norwich Pharmacal Co.), The Journal, March 27, 1909, p. 1047; July 17, 1915, p. 272; Reports Chem. Lab., 1909, p. 21; Propaganda, vol. 1, p. 254. Unguentum Carbonis Comp. (Hilf) (Hilf Products Co.), The Journal, Nov. 23, 1929, p. 1646; Reports Council Pharm. & Chem., p. 55. Unguentum Selenio Vanadic (v. Roemer) (A. von Roemer), The Jour- nal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1014, p. 129; Propaganda, vol. 1, 207. Unicorn Root, The Journal, Jan. 22, 1910, p. 304; Reports Council Pharm. & Chem., 1910, p. 10; Propaganda, ed. 9, p. 208. Uranoblen (A. Grimme), Reports Council Pharm. & Chem., 1915, p. 176. Urasal (Frank W. Horner, Inc.), The Journal, July 28, 1928, p. 247; Reports Council Pharm. & Chem., 1928, p. 67. Urasol (Organic Chemical Mfg. Co.), The Journal, Sept. 5, 1908. p. 818; May 8, 1909, p. 1511; Reports Council Pharm. & Chem., 1905-8, p. 166; 1909, p. 64; Reports Chem. Lab., 1924-5, p. 119. Uricedin (Fischer Chemical Importing Co.), The Journal, Nov. 2i, 1907, p. 1788; Reports Chem. Lab., 1909, p. 20; Propaganda, vol. 1, p. 256. BIBLIOGRAPHICAL INDEX Ixi Uricsol (Uricsol Chemical Co.), The Journal, Aug. 14, 1915, p. 638; Reports Council Pharm. & Chem., 191S, p. 149; Reports Chem. Lab., 1915, p. 96; Propaganda, vol. 2, p. 30. Uriseptin (Gardner-Barada Chemical Co.), The Journal, Aug. 29, 1908, p. 77Z; Reports Chem. Lab., to 1909, p. 40; Propaganda, vol. 1, p. 256. Urodonal (Geo. J. Wallau, Inc.), The Journal, Aug. 14, 1915, p. 639; June 17, 1933, p. 1955; Reports Council Pharm. & Chem., 1915, p. 153; Propaganda, vol. 2, p. 32. Uron (Uron Chemical Co.), The Journal, Nov. 3,' 1906, p. 1500; Reports Council Pharm. & Chem., 1905-8, p. 26. Urotex, The Journal, Feb. 17, 1934, p. 561. Uterine Sedative, Elixir (Eli Lilly & Co.), The Journal, Aug. 31, 1912, p. 7il; Reports Council Pharm. & Chem., 1912, p. 44; Propaganda, vol. 1, p. 410. Uterine Tonic, Buckley (The Abbott Laboratories), Reports Council Pharm. & Chem., 1912, p. 41. Uterine Tonic, Girard (Girard Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 41. Uterine Tonic (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 46. Uterine Tonic, Elixir (F. Stearns & Co.), Reports Council Pharm. & Chem., 1912, p. 46. Uterine Tonic (Tablet) (Maltbie Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 41. Uterine Wafers, Naphey's Medicated, see Naphey's Medicated Uterine Wafers. Uterine Wafers, Micajah's (Micajah & Co.), The Journal, March 26, 1910, p. 1070; Sept. 25, 1915, p. 1128; Reports Council Pharm. & Chem., 1916, p. 66; Reports Chem. Lab., 1910, p. 18; 1915, p. 100; Propaganda, vol. 1, p. 240. Utero Tonic (Nelson, Baker & Co.), Reports Council Pharm. & Chem., 1912, p. 46. Utros (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912, p. 46. Vaccine, Friedmann's (Standard Distributing Co.), Reports Council Pharm. & Chem., 1914, p. 136. Vaccine, Non-Virulent Tubercle Bacillus (G. H. Sherman). — See Tubercle Vaccine, Sherman's Non-Virulent. Vaccine, von Ruck (Dr. Karl von Ruck), The Journal, Dec. 7, 1935, p. 1935. Vaccines, Mixed, The Journal, June 22, 1918, p. 1967; Reports Council Pharm. & Chem., 1918, p. 11; Propaganda, vol. 2, p. 184. See also B. Coli Combined Vaccine (Abbott Laboratories) ; Catarrhal Vaccine Combined-Lilly: Catarrhal Vaccine No. 6 (G. H. Sherman); Colon Bacillus Combined Vaccine (Modified Van Cott) No. 35 (G. H. Sherman) ; Erysipelas Vaccine No. 1 (G. H. Sherman) ; Friedlander Vaccine No. 36 (G. H. Sherman); Influenza Mixed Vaccine-Lilly; Influenza Vaccine No. 38 (G. H. Sherman) ; Influenza Serobacterin Mixed-Mulford; Micrococcus Catarrhalis Combined Vaccine (Abbott Laboratories); Mixed Staphylococcus Acne Vaccine; Mixed Vaccine No. 40, Sherman's; Pertussis Bacterin Mixed (H. K. Mulford); Pertussis Combined-Bacterin (Abbott Laboratories) ; Pertussis Serobacterin Mixed-Mulford; Pneumo. Mixed Vaccine No. 6 (G. H. Sherman); Staph- Acne Vaccine (Cutter Laboratory); Streptococ- cus-Rheumaticus-Combined Bacterin (Abbott Laboratories) ; Strep- tococcus- Viridans-Combined-Bacterin (Abbott Laboratories) ; Strepto- Staph Vaccine No, 10 (G. H. Sherman); Whooping Cough Mixed Vaccine (G. H. Sherman). Vaccino Antigonococcico Bruschettini (Pagano Drug Co.), The Journal, April 4, 1931, p. 1145; Reports Council Pharm. & Chem., 1931. p. 97. Vaccino Antipiogeno Bruschettini (Pagano Drug Co.), The Journal, April 4, 1931, p. 1145; Reports Council Pharm. & Chem., 1931, p. 97. Vacher-Balm (E. W. Vacher, Inc.), Reports Council Pharm. & Chem., 1922, p. 61. Valamin (American Kreuger and Toll Corporation), The Journal, Dec. 13, 1924, p. 1941; Reports Council Pharm. & Chem., 1924, p. 75. Vanadic Acid, The Journal, May 9, 1908, p. 1548; July 24, 1909, p. 309. Ixii BIBLIOGRAPHICAL INDEX Vanadiol (Vanadium Chemical Co.), The Journal, Jan. 18, 1913, p. 225; Reports Council Pharm. & Chem., 1913, p. 7; Propaganda, vol. 1, p. 209. Vanadioseptol (Vanadium Chemical Co.), The Journal, Jan. 18, 1913, p. 225; Reports Council Pharm. & Chem., 1913, p. 7; Propaganda, vol. 1, p. 209. Vanadium, The Journal, June 3, 1911, p. 1648. Vanadium Solution for Intravenous and Hypodermic Use (Vanadium Chemical Co.), The Journal, Jan. 18, 1913, p. 225; Reports Council Pharm. & Chem., 1913, p. 7; Propaganda, vol. 1, p. 209. Vanadoforms (Vanadium Chemical Co.), The Journal, Jan. 18, 1913, p. 225; Reports Council Pharm. & Chem., 1913, p. 7; Propaganda, vol. 1, p. 209. Vapo-Cresolene (Vapo-Cresolene Co.), The Journal, April 4, 1908, p. 1135; Reports Chem. Lab., to 1909, p. 65; Propaganda, vol. 1, p. 408. Vasogen (Lehn & Fink), The Journal, Feb. 13, 1909, p. 575; Propa- ganda, vol. 1, p. 408. Vege Mucene (BioVegetin Products, Inc.), The Journal. Jan. 25, 1935, p. 316; Reports Council Pharm. & Chem., 1934, p. 125. Vege-Sea (Oakland Food Products Co.), The Journal, Feb. 20, p. 640; Reports Council Pharm. & Chem., 1932, p. 96. V-E-M with Boric Acid (Schoonmaker Laboratories, Inc.), Reports Coun- cil Pharm. & Chem., 1917, p. 163; Propaganda, vol. 2, p. 167. V-E-M with Camphor (Schoonmaker Laboratories, Inc.), Reports Council Pharm. & Chem., 1917, p. 163; Propaganda, vol. 2, p. 167. V-E-M with Ichthyol (Schoonmaker Laboratories, Inc.), Reports Council Pharm. & Chem., 1917, p. 163; Propaganda, vol. 2, p. 167. V-E-M with Stearate of Zinc (Schoonmaker Laboratories, Inc.), Reports Council Pharm. & Chem., 1917, p. 163; Propaganda, vol. 2, p. 1_67. V-E-M Unguentum Eucalyptol Compound (Schoonmaker Laboratories, Inc.), Reports Council Pharm. & Chem., 1917, p. 163; Propaganda, vol. 2, p. 167. Venarsen (Intravenous Products Co.), The Journal, May 22, 1915, p. 1780; March 25, 1916, p. 978; Reports Council Pharm. & Chem., 1915, p. 52; Reports Chem. Lab., 1915, p. 82; Propaganda, ed. 9, p. 212; Propaganda, vol. 2, p. 471. Vencalxodine (Intravenous Products Co.), The Journal, Feb. 16, 1918, p. 481. Venodine (Intravenous Products Co.), The Journal, June 26, 1915, p. 2155; March 25, 1916, p. 278; Reports Council Pharm. & Chem., 1915, p. 145; Propaganda, vol. 1, p. 214. Venomer (Intravenous Products Co.), The Journal, March 25, 1916, p. 978. Venosal (Intravenous Products Co.), The Journal, Jan. 5, 1918, p. 48; Reports Council Pharm. & Chem., 1917, p. 118; Reports Chem. Lab., 1917, p. 57; Propaganda, vol. 2, pp. 169, 435. Veracolate (Marcy Co.), The Journal, April 30, 1910, p. 1458; Aug. 1, 1914, p. 420; April 24, 1915, p. 1440; Reports Council Pharm. & Chem., 1915, p. 141; Propaganda, vol. 1, pp. 216, 344. Veracolate with Iron, Quinine and Strychnine (Marcy Co.), The Jour* NAL, April 24, 1915, p. 1440; Reports Council Pharm. & Chem., 1915, p. 141. Veracolate with Pepsin and Pancreatin (Marcy Co.), The Journal, April 24, 1915, p. 1440; Reports Council Pharm. & Chem., 1915, p. 141. Veroform Germicide (Veroform Hygienic Co.), The Journal, Nov. 22, 1913, p. 1920; Reports Council Pharm. & Chem.. 1913; p. 29. Viburn-Ovaro (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 46. Viburnum Compound, Hayden's (New York Pharmacal Co.), The Jour- nal, Aug. 31, 1912, p. 735; Jan. 23, 1915, p. 359; Reports Council Pharm. & Chem., 1914, p. 95; Propaganda, vol. 1, pp. 218, 409. Viburnum Compound, Elixir (Nelson. Baker & Co.), The Journal, Aug. 31, 1912, p. 735; Propaganda, vol. 1, p. 410. Viburnum Compound (Tablets) (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 41. Viburnum Compound (Tablet) (Uterine Tonic), (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 46. BIBLIOGRAPHICAL INDEX Ixiii Viburnum Compound (Tablet), (Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912, p. 46. Viburnum Sedative (Fraser Tablet Co.), Reports Council Pharm, & Chem., 1912, p. 46. Viburnumal (Louisville Pharmacal Works), The Journal, Aug. 31, 1912, p. 735; Reports Council Pharm. & Chem., 1912, p. 44; Propa- ganda, vol. 1, p. 410. Vibutero (F. Stearns & Co.), The Journal, Aug. 31, 1912, p. 735; Reports Council Pharm. & Chem., 1912, p. 46; Propaganda, vol. 1, p. 410. Vi-Cris (Vi-Cris, Inc.), The Journal, June 24, 1933, p. 2009; Reports Council Pharm. & Chem., 1933, p. 176. Vigantol (Winthrop Chemical Co.), The Journal, Oct. 5, 1929, p. 1067; Feb. 8, 1930, p. 410; Reports Council Pharm. & Chem., 1930, p. 85. Vigoral (Armour & Co.), The Journal, Jan. 23, 1909, p. 311; Propa- ganda, vol. 1, 472. Viking Palatable Cod Liver Oil (Viking Health Products Co.), The Journal, May 4, 1929, p. 1561; Reports Council Pharm. & Chem., 1929, p. 57. Vin Mariani (Mariani & Co.), The Journal, Nov. 24, 1906, p. 1751; Reports Council Pharm. & Chem., 1905-8, p. 29; Propaganda, vol. 1, p. 221. Viriligen (G. W. Carnrick Co.), The Journal, Feb. 28, 1925, p. 695; Reports Council Pharm. & Chem., 1925, p. 84. Virol (Etna Chemical Co.), The Journal, Feb. 20, 1915, p. 683; Reports Council Pharm. & Chem., 1915, p. 132; Propaganda, vol. 1, 225. "Vita-Cell" Preparations (Godissart & Pyles), The Journal, Oct. 27, 1934, p. 1309; Reports Council Pharm. & Chem., 1934, p. 127. Vitalait (Vitalait Laboratory. Newton Centre, Mass.), The Journal, Dec. 19, 1925, p. 1985; Reports Council Pharm., 1925, p. 81. Vitalait Culture Bacillus Bulgaricus (Vitalait Laboratory of California), The Journal, June 4, 1927, p. 1831; Reports Council Pharm. & Chem., 1927, p. 20. Vitalait Starter (Vitalait Laboratory. Newton Centre, Mass.), The Jour- nal, Jan. 23, 1926, p. 294; Reports Council Pharm. & Chem., 1925, p. 82. Vitalipon (C. G. Crosby), The Journal, July 7, 1928, p. 29; Reports Council Pharm. & Chem., 1928, p. 69. Vitamin A and Urinary Lithiasis, Reports Council Pharm. & Chem., 1935, p. 127. Vitamin Therapy, Shotgun, Reports Council Pharm. & Chem., 1935, p. 106. Vitanol (Daub Chemical Co.), The Journal, Nov. 7, 1925, p. 1504; Reports Council Pharm. & Chem., 1925, p. 83. Vitaphos (The Grain Chemical Company, Inc.), Reports Council Pharm. & Chem., 1921, p. 74. Vitova (S. Kirsch Import Co.), Reports Council Pharm. & Chem., 1932, p. 97. Von Ruck Vaccine (Dr. Karl von Ruck), The Journal, Dec. 7, 1935, p. 1935. Wagner's Carbonated Phosphate, (W. T. Wagner's Sons), The Journal, May 23, 1925, p. 1589; Reports Council Pharm. & Chem., 1925, p. 67. Wagner's "Em's" Kraenchen Water (W. T. Wagner's Sons), The Jour- nal, May 23, 1925, p. 1589; Reports Council Pharm. & Chem., 1925, p. 66. Wagner's Piperazine Water (W. T. Wagner's Sons), The Journal, May 23, 1925, p. 1589; Reports Council Pharm. & Chem., 1925, p. 67. Wagner's Special "C" (W. T. Wagner's Sons), The Journal, May 23, 1925. p. 1589; Reports Council Pharm. & Chem., 1925, p. 67. Warninks Advocaat (Julius Wile, Sons & Co.), The Journal, Nov. 12, 1927, p. 1711; Reports Council Pharm. & Chem., 1927, p. 99. Water, Buffalo Lithia Springs (Buffalo Lithia Springs Water Co.), The Journal, Sept. 12, 1908, p. 931. Waterbury's Compound (Waterbury Chemical Co.), The Journal, March 20, 1915, p. 1016; Reports Council Pharm. & Chem., 1915, p. 138; Propaganda, vol. 1, p. 57. Ixiv BIBLIOGRAPHICAL INDEX Water, Eryngo, Reports Council Pharm. & Chem., 1912, p. 47. Whiteruss (Lubric Oil Co.), The Journal, July 10, 1915, p. 175. White Sulphur Salts (White Sulphur Springs, Inc.), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 128. Whole Ovary-H. W. & D. (Hynson, Westcott & Dunning), The Jour- nal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 54. Whole Ovary-Lederle (Lederle Laboratories, Inc.), The Journal, June 24, 1930, p. 1997; Reports Council Pharm. & Chem., 1930, p. 54. Whole Pituitary Desiccated-Lederle (Lederle Laboratories, Inc.), The Journal, July 19, 1930, p. 201; Reports Council Pharm. & Chem., 1930, p. 54. Whooping Cough Bacterin No. 44 (Persson) (Persson Laboratories), Reports Council Pharm. & Chem., 1922, p. 22. Whooping Cough Mixed Vaccine No. 43 (G. H. Sherman), The Jour- nal, Oct. 11, 1924, p. 1184; Reports Council Pharm. & Chem., 1924, p. 58. Whooping Cough Vaccine X Plain (Cook Laboratories, Inc.). The Jour- nal, Feb. 21, 1931, p. 613; Reports Council Pharm. & Chem., 1930, p. 54. Wild Indigo, The Journal, Jan. 22, 1910, p. 304; Reports Council Pharm. & Chem., p. 19; Propaganda, vol. 1, p. 208. Wild Yam, The Journal, Jan. 22, 1910, p. 304; Reports Council Pharm. & Chem., 1910, p. 10; Propaganda, vol. 1, p. 208. Wine, Chapoteaut's (E. Fougera & Co., Inc.), The Journal, Dec. 19, 1914, p. 2247; Reports Council Pharm. & Chem., 1914, p. 77; Propa- ganda, vol. 1, p. 60. Wine, Stearns' (F. Stearns & Co.), Reports Council Pharm. & Chem., 1915, p. 177. Worlds Wonder Remedy (W. W. Remedy Co., Superior, Wis.), Reports Council Pharm. & Chem., 1918, p. 82. Xanol (Wm. S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1911, p. 64. Yadil (E. Fougera & Co., Inc.), The Journal, Aug. 16, 1924, p. 550; Feb. 14, 1925, p. 520. Yeastone (Merck & Co.), The Journal, Sept. 25, 1926, p. 1055. Yeast Vitamin-Harris Tablets (The Harris Laboratories), The Journal, Nov. 2, 1934, p. 1378; Reports Council Pharm. & Chem., 1934, p. 129. Yellow Bone Marrow Concentrate (Armour & Co.), The Journal, August 31, 1935, p. 667. Yogurt (Yogurt Co.), The Journal, Jan. 30, 1909, pp. 372, 379. Yohimbin Spiegel (Lehn & Fink), The Journal, March 30, 1907, p. 1127. Zemacol (Norwich Pharmacal Co.), The Journal, May 14, 1910, p. 1626; Report Chem. Lab., 1910, p. 42; Propaganda, vol. 1, p. 259. Zinc-Borocyl (Al-Sano Chemical Products Co.), The Journal, May 24, 1924, p. 1712; Reports Council Pharm. & Chem., 1924, p. 77. Ziratol (Bristol-Myers Co.), The Journal, Oct. 6, 1917, p. 1191; Reports Council Pharm. & Chem., 1917, p. 55; Reports Chem. Lab., 1917, p. 51; Propaganda, vol. 2, p. 148. Zonite (Zonite Products Co.), The Journal, April 7, 1923, p. 1024; Dec. 7, 1929, p. 1830. Zyme-oid (Oxychlorin Chemical Co.), The Journal, May 23, 1908, p. 1706; Reports Chem. Lab., to 1909, p. 34; Propaganda, vol. 1, p. 261; Reports Chem. Lab., 1921, p. 52. Zymotoid, Arnold's (Zymotoid Co.), The Journal, April 6, 1912, p. 1030; Reports Chem. Lab., 1912, p. 68; Propaganda, vol. 1, p. 412.